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. 2017 Jun 19;2017(6):CD006961. doi: 10.1002/14651858.CD006961.pub4

for the main comparison.

Combination antimicrobial susceptibility testing compared with conventional treatment (separate testing) for pulmonary exacerbation due to Pseudomonas aeruginosa in people with cystic fibrosis
Patient or population: adults and children with pulmonary exacerbation due to Pseudomonas aeruginosa
Settings: inpatient
Intervention: combination antimicrobial susceptibility testing
Comparison: conventional treatment (separate susceptibility testing)
Outcomes Illustrative comparative risks* (95% CI) Relative effect
 (95% CI) Number of participants
 (studies) Quality of the evidence
 (GRADE) Comments
Assumed risk Corresponding risk
conventional treatment combination susceptibility testing
Lung function
 (FEV₁ or FVC L/min or % predicted)
Follow up: 14 days treatment with follow up every 3 months for up to 4.5 years
Outcome not reported ‐ see comment. N/A N/A N/A Lung function outcomes were not reported separately for individuals with infection due to Pseudomonas aeruginosa.
Time to next exacerbation
Follow up: up to 4.5 years
The only data available for the time to next exacerbation due to Pseudomonas aeruginosa gave a hazard ratio of 0.82 for the conventional (control) group compared to the combination antimicrobial susceptibility testing group (95% CI 0.44 to 1.51) (P = 0.52). N/A 1
(82)
⊕⊕⊕⊝
 moderate1  
Quality of life Outcome not reported ‐ see comment. N/A N/A N/A This outcome wasn't reported in the included study.
Length of hospital stay
Follow up: up to 4.5 years
Outcome not reported ‐ see comment. N/A N/A N/A This outcome was not reported separately for people with infection due to Pseudomonas aeruginosa.
Sputum bacterial density measured in colony forming units/mL
Follow up: up to 4.5 years
Outcome not reported ‐ see comment. N/A N/A N/A This outcome was not reported separately for people with infection due to Pseudomonas aeruginosa.
Adverse events
Follow up: up to 4.5 years
Outcome not reported ‐ see comment. N/A N/A N/A This outcome was not reported separately for people with infection due to Pseudomonas aeruginosa.
There were 9 serious adverse events in all participants: 2/64 in the combination antimicrobial susceptibility testing group and 7/68 in the control group (P = 0.17).
Mortality
Follow up: up to 4.5 years
Outcome not reported ‐ see comment. N/A N/A N/A This outcome was not reported separately for people with infection due to Pseudomonas aeruginosa.
There were 2 deaths in all participants during the study period, both in the control group.
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
 CI: confidence interval; N/A: not applicable.
GRADE Working Group grades of evidence
 High quality: further research is very unlikely to change our confidence in the estimate of effect.
 Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
 Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
 Very low quality: we are very uncertain about the estimate.

1. Downgrade once for imprecision as there is only one included study and therefore the number of participants is low.