Cochrane · systematic review · CD008319

Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis

Smith, S, Rowbotham, NJ, Charbek, E · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Cystic Fibrosis and Genetic Disorders2 versionsAMSTAR 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

current version

GRADE rated

No studies

Included studies

No studies 3 · 21.4%Ungraded 0 · 0%Very low 9 · 64.3%Low 2 · 14.3%Moderate 0 · 0%High 0 · 0%

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

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Summary of findings: Inhaled antibiotics compared with IV antibiotics

Population: children and adults with CF and an acute exacerbation

7 questions

Outcome	Effect	Evidence	Status / GRADE
Quality of life perceived change in lifestyle after treatment Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	1 study · 18 participants	Very low Downgraded: risk of bias
Time off work or school Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	NR	No studies
Lung function change in FEV1 after treatment Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	1 study · 18 participants	Very low Downgraded: risk of bias
Need for additional IV or oral antibiotics Summary of findings: Inhaled antibiotics vs IV antibiotics	RR 6.11 [0.33, 111.71]	1 study · 18 participants	Very low Downgraded: risk of bias
Time to next pulmonary exacerbation Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	1 study · 59 participants	Very low Downgraded: risk of bias
Adverse events Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	1 study · 18 participants	Very low Downgraded: risk of bias
Microbiology Emergence of resistant organisms Summary of findings: Inhaled antibiotics vs IV antibiotics	no estimate extracted	1 study · 59 participants	Very low Downgraded: risk of bias

Summary of findings: Inhaled antibiotics plus IV antibiotics compared with IV antibiotics only

Population: children and adults with pulmonary exacerbation in CF

7 questions

Outcome	Effect	Evidence	Status / GRADE
Quality of life: number of participants achieving MCID Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	RR 1.2 [0.61, 2.34]	1 study · 16 participants	Low Downgraded: risk of bias
Time off work or school Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	no estimate extracted	NR	No studies
Lung function: change in FEV1 % predicted from baseline Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	no estimate extracted	2 studies · 44 participants	Very low Downgraded: risk of bias, imprecision
Need for additional IV or oral antibiotics Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	no estimate extracted	NR	No studies
Time to next pulmonary exacerbation Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	no estimate extracted	1 study · 16 participants	Low Downgraded: risk of bias
Adverse events moderate adverse events experienced during and after treatment Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	no estimate extracted	1 study · 28 participants	Very low Downgraded: risk of bias, imprecision
Microbiology Emergence of resistant organisms Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics only	RR 2.25 [0.27, 19.04]	1 study · 28 participants	Very low Downgraded: risk of bias, imprecision