Cochrane · systematic review · CD009650
Interventions for the eradication of meticillin‐resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis
Lo, DKH, Muhlebach, MS, Smyth, AR · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
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
14
current version
GRADE rated
10
No studies
4
Included studies
NR
No studies 4 · 28.6%Ungraded 0 · 0%Very low 4 · 28.6%Low 6 · 42.9%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
Current version onlyActive treatment versus observation only for eradicating MRSA in people with cystic fibrosis
Population: adults or children with positive microbiological isolate of MRSA from a respiratory tract specimen
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eradication of MRSA: number of participants that were MRSA‐negativea Active treatment vs observation only | OR 1.72 [0.65, 4.55] | 2 studies · 68 participants | Low Downgraded: risk of bias, imprecision |
Time until next positive MRSA isolate (from clinically relevant respiratory culture) Active treatment vs observation only | no estimate extracted | NR | No studies |
Quality of life: CFRSD‐CRISS symptom score Active treatment vs observation only | no estimate extracted | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision |
Lung function: absolute change from baseline in FEV1 % predicted Active treatment vs observation only | no estimate extracted | 2 studies · 58 participants | Very low Downgraded: risk of bias, imprecision |
Growth: change from baseline in weight (kg) Active treatment vs observation only | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Frequency of exacerbations Active treatment vs observation only | no estimate extracted | 1 study · 32 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects of treatment Active treatment vs observation only | no estimate extracted | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision |
Oral plus nebulised antibiotics versus oral antibiotics plus nebulised placebo for eradicating MRSA in people with cystic fibrosis
Population: adults and children with cystic fibrosis and a positive microbiological isolate of MRSA from a respiratory tract specimen
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eradication of MRSA Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | OR 1.63 [0.19, 13.93] | 1 study · 25 participants | Low Downgraded: risk of bias, imprecision |
Time until next positive MRSA isolate (from clinically relevant respiratory culture) Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | no estimate extracted | NR | No studies |
Quality of life: absolute change in CFQ‐R respiratory domain score Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | no estimate extracted | 1 study · 25 participants | Very low Downgraded: risk of bias, imprecision |
Lung function: absolute change from baseline in FEV1 % predicted Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | no estimate extracted | 1 study · 25 participants | Low Downgraded: risk of bias, imprecision |
Growth Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | no estimate extracted | NR | No studies |
Frequency of exacerbations Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | no estimate extracted | NR | No studies |
Adverse effects of treatment Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo | OR 3 [0.11, 79.91] | 1 study · 29 participants | Low Downgraded: risk of bias, imprecision |
Comparison
Population: adults or children with positive microbiological isolate of MRSA from a respiratory tract specimen
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Eradication of MRSA (defined by negative respiratory culture at day 28 for MRSA) | OR 12.6 [2.84, 55.84] | 1 study · 41 participants | Low Downgraded: risk of bias, imprecision |
Eradication of MRSA (defined by ≥3 negative respiratory cultures for MRSA over 6 months) | OR 1.8 [0.62, 5.25] | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision |
Time until next positive MRSA isolate (from clinically relevant respiratory culture) | no estimate extracted | NR | No studies |
Lung function | no estimate extracted | 1 study · 35 participants | Low Downgraded: risk of bias, imprecision |
Frequency of exacerbations | OR 0.29 [0.06, 1.3] | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision |
Growth and nutritional status (weight at day 168) | no estimate extracted | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects of treatment | no estimate extracted | 1 study · 45 participants | Low Downgraded: risk of bias, imprecision |