Long‐term macrolides for non‐cystic fibrosis bronchiectasis: A systematic review and meta‐analysis

  title={Long‐term macrolides for non‐cystic fibrosis bronchiectasis: A systematic review and meta‐analysis},
  author={Qibiao Wu and Weixing Shen and Haibo Cheng and Xiqiao Zhou},
Long‐term macrolides are increasingly being prescribed for stable bronchiectasis. This meta‐analysis assessed the clinical effect of this treatment in bronchiectasis. A systematic review and meta‐analysis were carried out. All randomized, controlled trials (RCT) comparing long‐term macrolides with placebo and/or usual medical care, with outcome measures relating to efficacy and safety were selected. Nine RCT recruiting 530 patients were included. Compared with placebo and/or usual medical care… 
Effects of long-term use of macrolides in patients with non-cystic fibrosis bronchiectasis: a meta-analysis of randomized controlled trials
In patients with non-CF bronchiectasis, macrolide maintenance treatment can effectively reduce frequency of exacerbations, attenuate lung function decline, decrease sputum volume, improve quality of life, but may be accompanied with increased adverse events (especially diarrhea) and pathogen resistance.
A review of non‐cystic fibrosis bronchiectasis in children with a focus on the role of long‐term treatment with macrolides
A total of three randomized double‐blind placebo‐controlled trials conducted in adults showed that macrolides taken for 6‐12 months led to a significant reduction in exacerbation rates, and only one long‐term, randomized double-blind placebo-controlled trial was conducted in the pediatric population.
Long-term antibiotic treatment for non-cystic fibrosis bronchiectasis in adults: evidence, current practice and future use
This perspective provides an overview of evidence and current practice for long-term oral, inhaled and pulsed intravenous antibiotic therapy in adults with non-cystic fibrosis bronchiectasis.
Prolonged antibiotics for non-cystic fibrosis bronchiectasis in children and adults.
Available evidence shows benefit associated with use of prolonged antibiotics in the treatment of patients with bronchiectasis, at least halving the odds of exacerbation and hospitalisation and increasing the risk of emerging drug resistance.
Head-to-head trials of antibiotics for bronchiectasis.
Comparisons of the comparative effectiveness, cost-effectiveness, and safety of different antibiotics in the treatment of adults and children with bronchiectasis and their use is tempered against potential adverse effects and concerns regarding antibiotic resistance are evaluated.
Advantages and drawbacks of long-term macrolide use in the treatment of non-cystic fibrosis bronchiectasis.
The purpose of this paper is to review the efficacy and potential risks of these recent studies on the use of macrolides in non-CF bronchiectasis.
The evidence base for non‐CF bronchiectasis is finally evolving
The meta-analysis of macrolides in this issue of Respirology represents a watershed in the evolution of the therapeutic evidence base for this condition and provides further confirmatory evidence of the benefits of long-term macrolide therapy in non-CF bronchiectasis.
Management of bronchiectasis in adults
The recent addition of a bronchiectasis diagnosis‐related group to the Australian Refined Diagnostic Related Group classification system will allow definition of the disease burden within the Australian hospital system.
Bronchiectasis: Clinical Features and Management With a Focus on Inhaled Antibiotics
Current clinical practice in the routine management of noncystic fibrosis bronchiectasis is reviewed and emerging therapeutic options are discussed, with a particular focus on inhaled antibiotic therapy.
Impacts of Co-Existing Chronic Rhinosinusitis on Disease Severity and Risks of Exacerbations in Chinese Adults with Bronchiectasis
Chinese adults with bronchiectasis appear to have a lower prevalence of CRS than that in western countries, and patients with CRS had significantly greater risks of experiencing BEs during follow-up, suggesting proper treatment of upper airway symptoms due to CRS will be the prevention of infection or re-infection of the tracheobronchial tree.


Long-term macrolide therapy in chronic inflammatory airway diseases
In addition to direct antibacterial actions, 14- and 15-member-ring macrolides have immune modulating effects that appear to be the reason for clinical benefit in diffuse panbronchiolitis. A
Effect of azithromycin maintenance treatment on infectious exacerbations among patients with non-cystic fibrosis bronchiectasis: the BAT randomized controlled trial.
Among adults with non-CF bronchiectasis, the daily use of azithromycin for 12 months compared with placebo resulted in a lower rate of infectious exacerbations, which could result in better quality of life and might influence survival, although effects on antibiotic resistance need to be considered.
A pilot study of low-dose erythromycin in bronchiectasis.
The results of this pilot study show that low-dose erythromycin improves lung function and sputum volume in bronchiectasis.
Effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled trial.
Among patients with non-CF bronchiectasis, the 12-month use of erythromycin compared with placebo resulted in a modest decrease in the rate of pulmonary exacerbations and an increased rate of macrolide resistance.
[Impact of treatment with low dose roxithromycin on stable bronchiectasis].
  • Jifeng Liu, X. Zhong, Wei Zhong
  • Medicine
    Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
  • 2012
Low dose roxithromycin combined with ambroxol hydrochloride significantly improved degree of dyspnea, reduced scores for extent of bronchiectasis, scores for the bronchial wall thickening of bronchaectasis and the global CT score as compared to treatment withAmbroxol Hydrochloride alone in patients with bronchiECTasis in stable condition.
Quality of life and inflammation in exacerbations of bronchiectasis
Improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers, and all soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-α.
Effect of roxithromycin on airway responsiveness in children with bronchiectasis: a double-blind, placebo-controlled study.
It is indicated that roxithromycin may decrease the degree of airway responsiveness in patients with bronchiectasis and increasedAirway responsiveness and its clinical impact.