Pulmonology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
Pulmonology Institute and CF Center, Carmel Medical Center, Haifa, Israel.
Eur Respir Rev. 2024 Jan 31;33(171). doi: 10.1183/16000617.0178-2023.
is the most commonly isolated pathogen in bronchiectasis and is associated with worse outcomes. Eradication treatment is recommended by guidelines, but the evidence base is limited. The expected success rate of eradication in clinical practice is not known.
We conducted a systematic review and meta-analysis according to Meta-Analysis of Observational Studies in Epidemiology guidelines. PubMed, Embase, the Cochrane Database of Systematic Reviews and Clinicaltrials.gov were searched for studies investigating eradication treatment using antibiotics (systemic or inhaled) in patients with bronchiectasis. The primary outcome was the percentage of patients negative for at 12 months after eradication treatment. Cystic fibrosis was excluded.
Six observational studies including 289 patients were included in the meta-analysis. Our meta-analysis found a 12-month eradication rate of 40% (95% CI 34-45%; p<0.00001), with no significant heterogeneity (I=0%). Combined systemic and inhaled antibiotic treatment was associated with a higher eradication rate (48%, 95% CI 41-55%) than systemic antibiotics alone (27%, 13-45%).
Eradication treatment in bronchiectasis results in eradication of from sputum in ∼40% of cases at 12 months. Combined systemic and inhaled antibiotics achieve higher eradication rates than systemic antibiotics alone.
是支气管扩张症中最常分离出的病原体，与更差的结局相关。指南推荐进行根除治疗，但证据基础有限。在临床实践中，根除治疗的预期成功率尚不清楚。
我们根据观察性研究荟萃分析的流行病学指南进行了系统评价和荟萃分析。检索了 PubMed、Embase、Cochrane 系统评价数据库和 Clinicaltrials.gov，以调查使用抗生素（全身或吸入）治疗支气管扩张症患者的根除治疗的研究。主要结局是在根除治疗后 12 个月时 阴性的患者比例。排除囊性纤维化。
纳入了 6 项观察性研究，共 289 例患者。我们的荟萃分析发现，12 个月的根除率为 40%（95%CI 34-45%；p<0.00001），无显著异质性（I=0%）。联合全身和吸入抗生素治疗的根除率（48%，95%CI 41-55%）高于单独全身抗生素治疗（27%，13-45%）。
支气管扩张症的根除治疗可使痰中 12 个月的清除率达到 40%左右。联合全身和吸入抗生素治疗比单独全身抗生素治疗的根除率更高。
