Cochrane · systematic review · CD002203
Macrolide antibiotics (including azithromycin) for cystic fibrosis
Southern, KW, Solis-Moya, A, Kurz, D, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
Cystic Fibrosis and Genetic DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
18
No studies
10
Included studies
NR
No studies 10 · 35.7%Ungraded 0 · 0%Very low 6 · 21.4%Low 0 · 0%Moderate 9 · 32.1%High 3 · 10.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings ‐ oral azithromycin compared to placebo
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 % predicted: mean change from baseline Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 4 studies · 549 participants | High |
Pulmonary exacerbations: time to next exacerbation Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 4 studies · 796 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Adverse events: number of mild treatment‐related adverse events Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 4 studies · 748 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Hospitalisations: admissions to hospital Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 2 studies · 445 participants | High |
New acquisition of CF pathogens: PA Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 2 studies · 282 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Need for additional antibiotics: participants needing extra IV antibiotics Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 3 studies · 527 participants | High |
QoL: mean change in quality of life Summary of findings ‐ oral azithromycin vs placebo | no estimate extracted | 1 study · 177 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Summary of findings ‐ high‐dose azithromycin compared to low‐dose azithromycin
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 % predicted: Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations: rate of exacerbations per child per month Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | NR | No studies |
Hospitalisations Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | NR | No studies |
New acquisition of CF pathogens: PA Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | NR | No studies |
Need for additional antibiotics Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | NR | No studies |
QoL Summary of findings ‐ high‐dose azithromycin vs low‐dose azithromycin | no estimate extracted | NR | No studies |
Summary of findings ‐ nebulised azithromycin compared to oral azithromycin
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 % predicted: mean change from baseline Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations: time to next exacerbation Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | NR | No studies |
Adverse events: number of treatment‐related adverse events Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hospitalisations Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | NR | No studies |
New acquisition of CF pathogens: PA (mean change in PA count (log10 PA CFU/g sputum)) Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Need for additional antibiotics Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | NR | No studies |
QoL: change in PEDsQL‐4 scale Summary of findings ‐ nebulised azithromycin vs oral azithromycin | no estimate extracted | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings ‐ weekly azithromycin compared to daily azithromycin
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 % predicted: mean change % predicted Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | 1 study · 208 participants | Moderate Downgraded: imprecision |
Pulmonary exacerbations: number of days to first exacerbation Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | 1 study · 208 participants | Moderate Downgraded: imprecision |
Adverse events: number of treatment‐related adverse events Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | 1 study · 208 participants | Moderate Downgraded: imprecision |
Hospitalisations: mean number of hospital admissions Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | 1 study · 208 participants | Moderate Downgraded: imprecision |
New acquisition of CF pathogens: PA Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | NR | No studies |
Need for additional antibiotics Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | NR | No studies |
QoL: change in CFQ score Summary of findings ‐ weekly azithromycin vs daily azithromycin | no estimate extracted | 1 study · 208 participants | Moderate Downgraded: imprecision |