Cochrane systematic review - short courses of antibiotics for children and adults with bronchiectasis

Introduction Non-cystic fi brosis (CF) bronchiectasis is an important cause of respiratory morbidity in both developing and developed countries. Antibiotics are considered standard therapy in the treatment of this condition. In this Cochrane review, we examined the evidence for the effi cacy of short courses (4 weeks or less) for non-CF bronchiectasis in children and adults. Methods The Cochrane Airways Group performed a literature search, in accordance with Cochrane methodology. This included the Cochrane Central Register of Controlled Trials and clinical trial registers. Inclusion criteria were randomized controlled trials (RCT) comparing outcomes with use of antibiotics (intravenous, oral or inhaled) versus placebo or usual care (control), for periods of ≤4 weeks, in non-cystic fi brosis bronchiectasis. Results 187 abstracts were reviewed. A single eligible study showed a small benefi t, when compared to placebo, of 4 weeks of inhaled antibiotic therapy in adults with bronchiectasis and pseudomonas in their sputum. There were no studies in children and no studies on oral or intravenous antibiotics. Conclusion There is insuffi cient evidence in the current literature to make reasonable conclusions about the effi cacy of short course antibiotics in the management of adults and children with non-CF bronchiectasis. Until further evidence is available, adherence to current treatment guidelines is recommended