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Long-term macrolide treatment for non-cystic fibrosis bronchiectasis in children: a meta-analysis

Cited 3 time in Web of Science Cited 6 time in Scopus

Lee, Eun; Sol, In Suk; Kim, Jong Deok; Yang, Hyeon-Jong; Min, Taek Ki; Jang, Gwang Cheon; Hwang, Yoon Ha; Cho, Hyun-Ju; Suh, Dong In; Kim, Kyunghoon; Kim, Hwan Soo; Kim, Yoon Hee; Woo, Sung Il; Lee, Yong Ju; Jung, Sungsu; Jeon, You Hoon

Issue Date
Nature Publishing Group
Scientific Reports, Vol.11 No.1, p. 24287
Recurrent bacterial infection causes frequent bronchiectasis (BE) exacerbations. The effectiveness and safety of long-term administration of macrolides in BE remain controversial, especially in children who require minimal treatment to prevent exacerbation. We conducted this meta-analysis to determine the usefulness of long-term macrolide use in pediatric BE. We searched PubMed, Cochrane Library databases, Embase, KoreaMed, Igaku Chuo Zasshi, and Chinese National Knowledge Infrastructure databases. We identified randomized controlled trials (RCTs) which elucidated long-term macrolide treatment (>= 4 weeks) in non-cystic fibrosis BE in children aged < 18 years. The primary outcome was frequency of acute exacerbation; secondary outcomes included changes in pulmonary function, sputum scores, and adverse events including bacterial resistance. We included four RCTs. Long-term macrolide treatment showed a significant decrease in the frequency of exacerbation (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.10-0.87), mean number of exacerbations per patient (mean difference, - 1.40; 95% CI, - 2.26 to - 0.54), and sputum purulence score (mean difference, - 0.78; 95% CI, - 1.32 to - 0.24). However, long-term macrolide treatment was accompanied by an increased carriage of azithromycin-resistant bacteria (OR, 7.13). Long-term macrolide administration prevents exacerbation of BE in children; however, there are risks of increasing antibiotic resistance. Benefits and risks should be weighed and determined on a patient-by-patient basis.
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  • College of Medicine
  • Department of Medicine
Research Area 식품알레르기, 아토피피부염, 천식


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