Cochrane · systematic review · CD009764
Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD)
Herath, SC, Normansell, R, Maisey, S, et al. · Cochrane Database of Systematic Reviews · 2018 · 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
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 6 · 85.7%High 1 · 14.3%
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 onlyAntibiotics versus placebo for COPD
Population: Adults (aged 40 or over) with COPD presenting with 1 or more exacerbations in the previous year. The two larger studies (Albert 2011; Sethi 2010) recruited participants who required systemic steroids or antibiotics for exacerbations or participants on supplemental oxygen
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of people with one or more exacerbations WMD of Antibiotics vs placebo | OR 0.57 [0.42, 0.78] | 8 studies · 2716 participants | Moderate Downgraded: inconsistency |
Rate of exacerbation per patient/year WMD of Antibiotics vs placebo | Rate ratio 0.67 [0.54, 0.83] | 5 studies · 1384 participants | Moderate Downgraded: inconsistency |
HRQoL, SGRQ (total score) Scale from: 0 to 100. SGRQ comprises responses to 50 items, 0 being the best possible score and 100 the worst. WMD of Antibiotics vs placebo | no estimate extracted | 7 studies · 2237 participants | High |
All‐cause mortality WMD of Antibiotics vs placebo | OR 0.87 [0.66, 1.15] | 6 studies · 3309 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Serious adverse events WMD of Antibiotics vs placebo | OR 0.88 [0.74, 1.05] | 9 studies · 2978 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Any adverse event WMD of Antibiotics vs placebo | OR 1.07 [0.69, 1.67] | 4 studies · 512 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
FEV1 (mL) WMD of Antibiotics vs placebo | no estimate extracted | 6 studies · 658 participants | Moderate Downgraded: imprecision, inconsistency, indirectness |
Antibiotics versus placebo for COPD
Population: Adults (aged 40 or over) with COPD presenting with 1 or more exacerbations in the previous year. The 2 larger studies (Albert 2011; Sethi 2010) recruited patients who required systemic steroids or antibiotics for exacerbations or patients on supplemental oxygen
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of people with one or more exacerbations Antibiotics vs placebo | OR 0.64 [0.45, 0.9] | 4 studies · 2411 participants | Moderate Downgraded: inconsistency |
Number of people with one or more exacerbations ‐ Continuous antibiotics Antibiotics vs placebo | OR 0.55 [0.39, 0.77] | 3 studies · 1262 participants | High |
Number of people with one or more exacerbations ‐ Pulsed antibiotics Antibiotics vs placebo | OR 0.87 [0.69, 1.09] | 1 study · 1149 participants | Moderate |
Rate of exacerbation per patient/year (Continuous antibiotic use) Antibiotics vs placebo | Rate Ratio 0.73 [0.58, 0.91] | 3 studies · 1262 participants | Moderate Downgraded: inconsistency |
HRQOL, SGRQ (change in total score) Scale from: 0 to 100. SGRQ comprises of responses to 50 items, 0 being the best possible score and 100 the worst. Antibiotics vs placebo | no estimate extracted | 3 studies · 1962 participants | Moderate Downgraded: risk of bias, inconsistency |
All cause mortality Antibiotics vs placebo | OR 0.89 [0.67, 1.19] | 3 studies · 2841 participants | Moderate |
Serious adverse events Antibiotics vs placebo | OR 0.88 [0.73, 1.07] | 4 studies · 2411 participants | Moderate |