Integrált kutatói utánpótlás-képzési program az informatika és számítástudomány diszciplináris
te...(EFOP-3.6.3-VEKOP-16-2017-00002) Támogató: EFOP-VEKOP
GINOP - STAY ALIVE(GINOP-2.3.2-15-2016-00048) Támogató: Nemzeti Kutatási, Fejlesztési
és Innovációs Hivatal
Szakterületek:
Metaanalízis
Pseudomonas infection is a major determinant of morbidity and mortality in cystic
fibrosis (CF). Maintaining optimal lung function in CF patients carrying Pseudomonas
remains a challenge. Our study aims to investigate the efficacy of antipseudomonal
inhaled antibiotics in CF patients with chronic Pseudomonas infection. A Bayesian
network meta-analysis of randomized controlled trials was conducted. The main outcomes
were changes in: (a) forced respiratory volume (FEV1), (b) Pseudomonas aeruginosa
sputum density, and (c) CF Questionnaire Revised Respiratory Symptom Score (CFQR-RSS)
at 4 weeks follow-up. Eighteen trials which reported on treatment with aztreonam lysine,
tobramycin, colistin, levofloxacin, fosfomycin/tobramycin, and amikacin in various
dosages were eligible for inclusion. In terms of change in FEV1%, aztreonam lysine
(t.i.d., 75 mg) with a 28-day run in the tobramycin phase, aztreonam lysine (b.i.d.,
75 mg) with a 28-day run in the tobramycin phase had the highest probability of being
the most effective treatment (SUCRAs were 77, 76%, respectively). Regarding change
in Pseudomonas sputum density, aztreonam lysine (b.i.d., 75 mg) with a 28-day run
in the tobramycin phase, aztreonam lysine (t.i.d., 75 mg) with a 28-day run in the
tobramycin phase had the highest probability of being the most effective treatment
(SUCRAs were 90, 86%, respectively). Regarding change in CFQR-RSS, aztreonam lysine
(t.i.d., 75 mg) and aztreonam lysine (b.i.d., 75 mg) with a 28-day run in the tobramycin
inhalation solution phase had the highest probability of being the most effective
treatments (SUCRA:74% and 72%, respectively). Regarding changes in FEV1% and Pseudomonas
sputum density, aztreonam lysine with a run in tobramycin phase may be the best treatment
option in treating chronic Pseudomonas in CF. According to CFQR-RSS no significant
differences were found. Given the limitations of the studies included, validation
trials are called for.
