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. |
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*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.