Cochrane · systematic review · CD010257
Antibiotics for exacerbations of chronic obstructive pulmonary disease
Vollenweider, DJ, Frei, A, Steurer‐Stey, CA, 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
10
current version
GRADE rated
10
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 20%Moderate 7 · 70%High 1 · 10%
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 compared to placebo for exacerbations of chronic obstructive pulmonary disease: outpatients
Population: exacerbations of COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure within 4 weeks ‐ current drugs only Antibiotics vs placebo | RR 0.72 [0.56, 0.94] | 7 studies · 1191 participants | Low Downgraded: imprecision, inconsistency |
All‐cause mortality Antibiotics vs placebo | OR 1.27 [0.49, 3.3] | 1 study · 301 participants | Low Downgraded: imprecision, inconsistency |
Antibiotics compared to placebo for exacerbations of chronic obstructive pulmonary disease: inpatients
Population: exacerbations of COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure within 4 weeks ‐ current drugs only ‐ inpatient Antibiotics vs placebo | RR 0.65 [0.38, 1.12] | 4 studies · 576 participants | Moderate Downgraded: imprecision |
Treatment failure within 4 weeks ‐ drugs not currently used ‐ ICU Antibiotics vs placebo | RR 0.19 [0.08, 0.45] | 1 study · 93 participants | Moderate Downgraded: imprecision |
Duration of hospital stay (days) ‐ inpatients Antibiotics vs placebo | no estimate extracted | 3 studies · 300 participants | High |
Duration of hospital stay (days) ‐ ICU patients Antibiotics vs placebo | no estimate extracted | 1 study · 94 participants | Moderate Downgraded: imprecision |
All‐cause mortality ‐ inpatients Antibiotics vs placebo | OR 2.48 [0.94, 6.55] | 2 studies · 214 participants | Moderate Downgraded: imprecision |
All‐cause mortality ‐ ICU patients Antibiotics vs placebo | OR 0.21 [0.06, 0.72] | 1 study · 93 participants | Moderate Downgraded: imprecision |
Antibiotics compared to placebo overall for exacerbations of chronic obstructive pulmonary disease; adverse events
Population: exacerbations of COPD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse events ‐ diarrhoea Antibiotics vs placebo overall | OR 1.68 [0.92, 3.07] | 5 studies · 1099 participants | Moderate Downgraded: imprecision |
Adverse events ‐ overall (any adverse events not specified) Antibiotics vs placebo overall | OR 1.2 [0.89, 1.63] | 6 studies · 1544 participants | Moderate Downgraded: imprecision |
Antibiotics for exacerbations of chronic obstructive pulmonary disease
Population: patients with exacerbations of chronic obstructive pulmonary disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure up to 4 weeks1 Subgroup: outpatient | RR 0.75 [0.6, 0.94] | 7 studies · 931 participants | Low Downgraded: imprecision, inconsistency |
Treatment failure up to 4 weeks1 Subgroup: inpatient | RR 0.77 [0.65, 0.91] | 4 studies · 612 participants | High |
Treatment failure up to 4 weeks1 Subgoup: ICU | RR 0.19 [0.08, 0.45] | 1 study · 93 participants | High |
All‐cause mortality Subgroup: inpatients | OR 1.02 [0.37, 2.79] | 4 studies · 531 participants | Low Downgraded: imprecision, inconsistency |
All‐cause mortality Subgroup: ICU | OR 0.21 [0.06, 0.72] | 1 study · 93 participants | High |
Adverse events ‐ diarrhoea | OR 2.62 [1.11, 6.17] | 3 studies · 698 participants | High |
Adverse events ‐ overall (adverse events not separated) | OR 1.53 [1.03, 2.27] | 5 studies · 1243 participants | Moderate Downgraded: imprecision, inconsistency |