Summary of findings for the main comparison. Fluoroquinolones compared to amoxicillin for bronchiectasis.
| Fluoroquinolones compared to amoxicillin for bronchiectasis: short‐term studies (< 4 weeks) | ||||||
| Patient or population: adults aged 18 years and above with diagnosis of non‐cystic fibrosis bronchiectasis Setting: hospital, Hong Kong Intervention: fluoroquinolones (Chan 1996: ciprofloxacin, 500 mg, oral, twice daily, 7 days; Lam 1989: ofloxacin, 200 mg, oral, thrice daily, 10 days) Comparison: amoxicillin (Chan 1996: 1000 mg, oral, 3 times per day, 7 days; Lam 1989: 1000 mg, oral, 3 times per day, 10 days) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with amoxicillin | Risk with fluoroquinolones | |||||
| Exacerbations | ‐ | ‐ | Not estimable | ‐ | ‐ | Outcome not reported in included studies |
| Serious adverse events | 0 per 1000 | 0 per 1000 (0 to 0) | Not estimable | 83 (2 RCTs) |
⊕⊕⊝⊝ LOWa,b | Evidence graded on the overall quality of the study |
| Response rate ‐ treatment failure | 429 per 1000 | 50 per 1000 (7 to 194) | OR 0.07 (0.01 to 0.32) | 83 (2 RCTs) | ⊕⊕⊝⊝ LOWa,b | |
| Response rate ‐ microbiological response | 2 out of 8 participants responded. | 8 out of 8 participants responded. | Peto OR 20.09 (2.83 to 142.59) | 16 (1 RCT) | ⊕⊕⊝⊝ LOWa,b | Small single study. Peto OR used owing to 100% response in intervention arm |
| Response rate ‐ improvement in sputum purulence (excellent) | 357 per 1000 | 566 per 1000 (348 to 761) | OR 2.35 (0.96 to 5.72) | 83 (2 RCTs) | ⊕⊝⊝⊝ VERY LOWa,b,c | |
| Deaths | 0 per 1000 | 0 per 1000 (0 to 0) | Not estimable | 83 (2 RCTs) |
⊕⊕⊝⊝ LOWa,b | No deaths reported. Evidence graded on the overall quality of the study |
| Quality of life | ‐ | ‐ | Not estimable | ‐ | ‐ | Outcome not reported in included studies |
| *The risk in the intervention group (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; OR: odds ratio; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence. High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aOne point deducted in relation to design and implementation of available studies suggesting likelihood of bias (unclear generation of randomisation sequence, potential selective reporting bias, and risk of other bias in Lam 1989).
bOne point deducted for imprecision (small sample size and few events).
cOne point deducted for imprecision (wide confidence interval).