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Cochrane Database of Systematic Reviews

Azithromycin for acute lower respiratory tract infections

Información

DOI:
https://doi.org/10.1002/14651858.CD001954.pub4Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 08 marzo 2015see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Infecciones respiratorias agudas

Copyright:
  1. Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

  • Malinee Laopaiboon

    Correspondencia a: Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

    [email protected]

    [email protected]

  • Ratana Panpanich

    Community Medicine, Faculty of Medicine, Chiang Mai, Thailand

  • Kyaw Swa Mya

    Department of Preventive and Social Medicine, University of Medicine, Yangon, Myanmar

Contributions of authors

In the original review Ratana Panpanich (RP) designed the protocol, identified studies, extracted data from the included studies and co‐wrote the review.
Peerasak Lerttrakarnnon (PL) co‐wrote the review and extracted data from the included studies. Malinee Laopaiboon (ML) helped analyse data and prepared the final draft of this review.
In the 2011 update ML contributed to all processes. RP contributed to 'Risk of bias' assessment and RP and PL also prepared the final draft of the updated review.
In this 2014 update ML contributed to all processes. RP and KW contributed to screening of studies and the final draft of the updated review.

Sources of support

Internal sources

  • Khon Kaen University, Faculty of Public Health, Thailand.

  • Chiang Mai University, Faculty of Medicine, Thailand.

External sources

  • Effective Health Care Alliance Program, Liverpool School of Tropical Medicine, Liverpool, UK.

  • Thailand Research Fund (Distinguished Research Professor Award), Thailand.

  • Thai Cochrane Network, Thailand.

Declarations of interest

Malinee Laopaiboon: I received an honorarium from the Thailand Research Fund, which is a non‐profit organisation.
Ratana Panpanich: none known.
Kyaw Swa Mya: none known.

Acknowledgements

We thank Professor Paul Garner for his kind advice on the protocol development and plan for data analysis. We are grateful to Dr. Shi Luming for her help in extracting data from the Chinese paper included in the review. We also thank the following people for commenting on the draft review: Gustav Malangu, Chantal Raherison, Mark Jones and Diederik van de Beek. We thank Liz Dooley and Sarah Thorning from the Cochrane Acute Respiratory Infections Group for their assistance with the preparation of this systematic review. The data presented and the views expressed are the responsibility of the review authors.

Version history

Published

Title

Stage

Authors

Version

2015 Mar 08

Azithromycin for acute lower respiratory tract infections

Review

Malinee Laopaiboon, Ratana Panpanich, Kyaw Swa Mya

https://doi.org/10.1002/14651858.CD001954.pub4

2008 Jan 23

Azithromycin for acute lower respiratory tract infections

Review

Malinee Laopaiboon, Ratana Panpanich, Peerasak Lerttrakarnnon

https://doi.org/10.1002/14651858.CD001954.pub3

2004 Oct 18

Azithromycin for acute lower respiratory tract infections

Review

Ratana Panpanich, Peerasak Lerttrakarnnon, Malinee Laopaiboon

https://doi.org/10.1002/14651858.CD001954.pub2

2000 Jul 24

Azithromycin for lower respiratory tract infections

Protocol

Ratana Panpanich, P Lerttrakarnnon

https://doi.org/10.1002/14651858.CD001954

Keywords

MeSH

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Funnel plot of comparison: 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, outcome: 1.1 Clinical failure.
Figuras y tablas -
Figure 3

Funnel plot of comparison: 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, outcome: 1.1 Clinical failure.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 1 Clinical failure.
Figuras y tablas -
Analysis 1.1

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 1 Clinical failure.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 2 Clinical failure by diagnosis.
Figuras y tablas -
Analysis 1.2

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 2 Clinical failure by diagnosis.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 3 Clinical failure by age group.
Figuras y tablas -
Analysis 1.3

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 3 Clinical failure by age group.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 4 Clinical failure by dose regimen of azithromycin.
Figuras y tablas -
Analysis 1.4

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 4 Clinical failure by dose regimen of azithromycin.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 5 Clinical failure by type of antibiotic in control group.
Figuras y tablas -
Analysis 1.5

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 5 Clinical failure by type of antibiotic in control group.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 6 Sensitivity analysis excluding one large trial.
Figuras y tablas -
Analysis 1.6

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 6 Sensitivity analysis excluding one large trial.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 7 Sensitivity analysis excluding three trials with missing data > 10%.
Figuras y tablas -
Analysis 1.7

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 7 Sensitivity analysis excluding three trials with missing data > 10%.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 8 Sensitivity analysis with the condition of concealment.
Figuras y tablas -
Analysis 1.8

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 8 Sensitivity analysis with the condition of concealment.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 9 Microbial eradication.
Figuras y tablas -
Analysis 1.9

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 9 Microbial eradication.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 10 Adverse events.
Figuras y tablas -
Analysis 1.10

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 10 Adverse events.

Comparison 1. Azithromycin versus amoxycillin or amoxycillin‐clavulanate

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical failure Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

2 Clinical failure by diagnosis Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Acute bronchitis

6

1296

Risk Ratio (M‐H, Random, 95% CI)

0.63 [0.45, 0.88]

2.2 Acute exacerbation of chronic bronchitis

9

808

Risk Ratio (M‐H, Random, 95% CI)

1.24 [0.46, 3.32]

2.3 Pneumonia

5

392

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.45, 1.94]

3 Clinical failure by age group Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Adult

12

2112

Risk Ratio (M‐H, Random, 95% CI)

1.15 [0.60, 2.20]

3.2 Paediatric

3

384

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.45, 1.94]

4 Clinical failure by dose regimen of azithromycin Show forest plot

12

2112

Risk Ratio (M‐H, Random, 95% CI)

1.15 [0.60, 2.20]

4.1 500 mg once daily x 3

8

1631

Risk Ratio (M‐H, Random, 95% CI)

1.25 [0.55, 2.83]

4.2 500 mg single dose followed by 250 mg on day 2 to 5

4

481

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.25, 3.62]

5 Clinical failure by type of antibiotic in control group Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

5.1 Amoxycillin

2

291

Risk Ratio (M‐H, Random, 95% CI)

0.41 [0.16, 1.05]

5.2 Amoxyclav

13

2205

Risk Ratio (M‐H, Random, 95% CI)

1.28 [0.71, 2.30]

6 Sensitivity analysis excluding one large trial Show forest plot

14

1742

Risk Ratio (M‐H, Random, 95% CI)

1.20 [0.69, 2.09]

7 Sensitivity analysis excluding three trials with missing data > 10% Show forest plot

12

2250

Risk Ratio (M‐H, Random, 95% CI)

1.13 [0.62, 2.03]

8 Sensitivity analysis with the condition of concealment Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

8.1 Adequately concealed studies

3

281

Risk Ratio (M‐H, Random, 95% CI)

0.55 [0.25, 1.21]

8.2 Inadequately or unclearly concealed studies

12

2215

Risk Ratio (M‐H, Random, 95% CI)

1.32 [0.70, 2.49]

9 Microbial eradication Show forest plot

12

961

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.87, 1.03]

10 Adverse events Show forest plot

12

2406

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.57, 1.00]

Figuras y tablas -
Comparison 1. Azithromycin versus amoxycillin or amoxycillin‐clavulanate