Short- versus long-duration antimicrobial treatment for exacerbations of chronic bronchitis: a meta-analysis

August 29, 2008 at 10:11 pm Leave a comment

Journal of Antimicrobial Chemotherapy  Sept 2008  V.62  N.3  p.442-450

Systematic review

Matthew E. Falagas1,2,3,*, Sofia G. Avgeri1, Dimitrios K. Matthaiou1, George Dimopoulos1,4 and Ilias I. Siempos1

1 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece 2 Department of Medicine, Tufts University School of Medicine, Boston, MA, USA 3 Department of Medicine, Henry Dunant Hospital, Athens, Greece 4 Intensive Care Unit, ‘Attikon’ University Hospital, Athens, Greece

Objectives: The aim of this study was to evaluate the comparative effectiveness and safety of short (5 days) and long (7 or 10 days) duration antimicrobial treatment of patients with acute exacerbations of chronic bronchitis (AECB).

Methods: We performed a meta-analysis of randomized controlled trials (RCTs) comparing regimens of the same antibiotic (same dosage and same route of administration) administered for a different time period. We searched PubMed, the Cochrane Central Register of Controlled Trials and reference lists from publications, with no language restrictions.

Results: Of the 1031 reports retrieved initially, seven RCTs, enrolling 3083 patients with AECB, met our inclusion criteria. The antimicrobials studied in these seven RCTs were quinolones, cefixime and clarithromycin. There was no difference between the short- and long-duration therapies with regard to treatment success in intention-to-treat [relative risk (RR) = 0.99, 95% confidence interval (CI) 0.95–1.03], clinically evaluable (RR = 0.99, 95% CI 0.96–1.02) or microbiologically evaluable (RR = 0.98, 95% CI 0.93–1.02) patients. Short-duration treatment, when compared with long, was associated with fewer adverse events (RR = 0.84, 95% CI 0.72–0.97).

Conclusions: Short-duration treatment seems to be as effective as and safer than long-duration antimicrobial treatment of patients with AECB. Additional research is required to clarify the long-term outcomes (namely the exacerbation-free interval after the resolution of an initial episode) of the compared regimens.

abstract
http://jac.oxfordjournals.org/cgi/content/abstract/62/3/442

Entry filed under: Antimicoticos, Infecciones respiratorias, Meta-Análisis.

Emergence and spread of azithromycin-resistant Neisseria gonorrhoeae in Scotland Interventions to control MRSA: high time for time-series analysis?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

Trackback this post  |  Subscribe to the comments via RSS Feed


Calendar

August 2008
M T W T F S S
« Jul   Sep »
 123
45678910
11121314151617
18192021222324
25262728293031

Most Recent Posts


%d bloggers like this: