Summary of findings 2. Polymyxins compared to aminoglycosides for bronchiectasis.
| Polymyxins compared to aminoglycosides for bronchiectasis: long‐term studies (≥ 4 weeks) | ||||||
| Patient or population: adults aged 18 years and above with diagnosis of bronchiectasis Setting: not reported Intervention: polymyxins (Dimakou 2014: 300 mg, inhalation using Pari LC Plus jet nebulizer, twice daily, 4 weeks; Kaponi 2017: 300 mg, inhalation using Pari LC Plus jet nebulizer, twice daily, 3 months) Comparison: aminoglycosides (Dimakou 2014: 1 MU, inhalation using Pari LC Plus jet nebulizer, twice daily, 4 weeks; Kaponi 2017: 1 MU, inhalation using Pari LC Plus jet nebulizer, twice daily, 3 months) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with aminoglycosides | Risk with polymyxins | |||||
| Exacerbation | ‐ | ‐ | Not estimable | ‐ | ‐ | Outcome not reported in included studies |
| Serious adverse events | 0 per 1000 | 0 per 1000 (0 to 0) | Not estimable | 20 (1 RCT) |
⊕⊝⊝⊝ VERY LOWa,b,c | Evidence graded on the overall quality of the study |
| Response rate ‐ improvement in sputum purulence | 800 per 1000 | 390 per 1000 (38 to 939) |
OR 0.16 (0.01 to 3.85) | 20 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b,d | Definition of improvement not reported |
| Response rate ‐ P aeruginosa eradication | 471 per 1000 | 554 per 1000 (242 to 826) |
OR 1.40 (0.36 to 5.35) | 35 (1 RCT) |
⊕⊝⊝⊝ VERY LOWa,b,d | Head‐to‐head comparison not reported directly |
| Deaths | 0 per 1000 | 0 per 1000 (0 to 0) | Not estimable | 20 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b,c | 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; P aeruginosa: Pseudomonas aeruginosa; 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 (all study methods unclear).
bOne point deducted for indirectness (no direct head‐to‐head comparisons).
cOne point deducted for imprecision (small sample size and few events).
dOne point deducted for imprecision (wide confidence intervals).