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Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

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Global distribution of studies.
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Figure 2

Global distribution of studies.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 3

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

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 4

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

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Analysis 1.1. Cates plot showing the absolute reduction in numbers of participants experiencing one or more exacerbations in adults treated with macrolides compared with placebo (OR 0.34, 95% CI 0.22 to 0.54). 714 people per 1000 in the placebo group experienced one or more exacerbations compared with 459 (95% CI 355 to 574) per 1000 in the macrolide group.
Figuras y tablas -
Figure 5

Analysis 1.1. Cates plot showing the absolute reduction in numbers of participants experiencing one or more exacerbations in adults treated with macrolides compared with placebo (OR 0.34, 95% CI 0.22 to 0.54). 714 people per 1000 in the placebo group experienced one or more exacerbations compared with 459 (95% CI 355 to 574) per 1000 in the macrolide group.

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Comparison 1 Macrolide versus placebo: adults, Outcome 1 ≥ 1 exacerbation.
Figuras y tablas -
Analysis 1.1

Comparison 1 Macrolide versus placebo: adults, Outcome 1 ≥ 1 exacerbation.

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Comparison 1 Macrolide versus placebo: adults, Outcome 2 Hospitalisation: all‐cause.
Figuras y tablas -
Analysis 1.2

Comparison 1 Macrolide versus placebo: adults, Outcome 2 Hospitalisation: all‐cause.

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Comparison 1 Macrolide versus placebo: adults, Outcome 3 Serious adverse events.
Figuras y tablas -
Analysis 1.3

Comparison 1 Macrolide versus placebo: adults, Outcome 3 Serious adverse events.

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Comparison 1 Macrolide versus placebo: adults, Outcome 4 Sputum weight (g): endpoint.
Figuras y tablas -
Analysis 1.4

Comparison 1 Macrolide versus placebo: adults, Outcome 4 Sputum weight (g): endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 5 FEV1 (% predicted): endpoint.
Figuras y tablas -
Analysis 1.5

Comparison 1 Macrolide versus placebo: adults, Outcome 5 FEV1 (% predicted): endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 6 FEV1 (% predicted): change (post bronchodilator).
Figuras y tablas -
Analysis 1.6

Comparison 1 Macrolide versus placebo: adults, Outcome 6 FEV1 (% predicted): change (post bronchodilator).

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Comparison 1 Macrolide versus placebo: adults, Outcome 7 FEV1 (L): endpoint.
Figuras y tablas -
Analysis 1.7

Comparison 1 Macrolide versus placebo: adults, Outcome 7 FEV1 (L): endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 8 FEV1 (L): change.
Figuras y tablas -
Analysis 1.8

Comparison 1 Macrolide versus placebo: adults, Outcome 8 FEV1 (L): change.

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Comparison 1 Macrolide versus placebo: adults, Outcome 9 FVC (% predicted): endpoint.
Figuras y tablas -
Analysis 1.9

Comparison 1 Macrolide versus placebo: adults, Outcome 9 FVC (% predicted): endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 10 FVC (L): endpoint.
Figuras y tablas -
Analysis 1.10

Comparison 1 Macrolide versus placebo: adults, Outcome 10 FVC (L): endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 11 FVC (L): change.
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Analysis 1.11

Comparison 1 Macrolide versus placebo: adults, Outcome 11 FVC (L): change.

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Comparison 1 Macrolide versus placebo: adults, Outcome 12 FEV1/FVC: endpoint.
Figuras y tablas -
Analysis 1.12

Comparison 1 Macrolide versus placebo: adults, Outcome 12 FEV1/FVC: endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 13 Adverse events.
Figuras y tablas -
Analysis 1.13

Comparison 1 Macrolide versus placebo: adults, Outcome 13 Adverse events.

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Comparison 1 Macrolide versus placebo: adults, Outcome 14 Azithromycin‐resistant bacteria (any).
Figuras y tablas -
Analysis 1.14

Comparison 1 Macrolide versus placebo: adults, Outcome 14 Azithromycin‐resistant bacteria (any).

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Comparison 1 Macrolide versus placebo: adults, Outcome 15 6‐Minute walk test: change.
Figuras y tablas -
Analysis 1.15

Comparison 1 Macrolide versus placebo: adults, Outcome 15 6‐Minute walk test: change.

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Comparison 1 Macrolide versus placebo: adults, Outcome 16 Quality of life: endpoint.
Figuras y tablas -
Analysis 1.16

Comparison 1 Macrolide versus placebo: adults, Outcome 16 Quality of life: endpoint.

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Comparison 1 Macrolide versus placebo: adults, Outcome 17 Quality of life: change.
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Analysis 1.17

Comparison 1 Macrolide versus placebo: adults, Outcome 17 Quality of life: change.

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Comparison 2 Macrolide versus no intervention: adults, Outcome 1 ≥ 1 exacerbation.
Figuras y tablas -
Analysis 2.1

Comparison 2 Macrolide versus no intervention: adults, Outcome 1 ≥ 1 exacerbation.

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Comparison 2 Macrolide versus no intervention: adults, Outcome 2 QoL SGRQ: endpoint total score.
Figuras y tablas -
Analysis 2.2

Comparison 2 Macrolide versus no intervention: adults, Outcome 2 QoL SGRQ: endpoint total score.

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Comparison 3 Macrolide versus placebo: children, Outcome 1 Hospitalisation: all‐cause.
Figuras y tablas -
Analysis 3.1

Comparison 3 Macrolide versus placebo: children, Outcome 1 Hospitalisation: all‐cause.

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Comparison 3 Macrolide versus placebo: children, Outcome 2 Serious adverse events.
Figuras y tablas -
Analysis 3.2

Comparison 3 Macrolide versus placebo: children, Outcome 2 Serious adverse events.

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Comparison 3 Macrolide versus placebo: children, Outcome 3 Sputum purulence score: endpoint.
Figuras y tablas -
Analysis 3.3

Comparison 3 Macrolide versus placebo: children, Outcome 3 Sputum purulence score: endpoint.

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Comparison 3 Macrolide versus placebo: children, Outcome 4 FEV1 (% predicted): endpoint.
Figuras y tablas -
Analysis 3.4

Comparison 3 Macrolide versus placebo: children, Outcome 4 FEV1 (% predicted): endpoint.

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Comparison 3 Macrolide versus placebo: children, Outcome 5 Adverse events.
Figuras y tablas -
Analysis 3.5

Comparison 3 Macrolide versus placebo: children, Outcome 5 Adverse events.

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Comparison 3 Macrolide versus placebo: children, Outcome 6 Azithromycin‐resistant bacteria (any).
Figuras y tablas -
Analysis 3.6

Comparison 3 Macrolide versus placebo: children, Outcome 6 Azithromycin‐resistant bacteria (any).

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Comparison 3 Macrolide versus placebo: children, Outcome 7 Azithromycin‐resistant Streptococcus pneumoniae.
Figuras y tablas -
Analysis 3.7

Comparison 3 Macrolide versus placebo: children, Outcome 7 Azithromycin‐resistant Streptococcus pneumoniae.

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Comparison 3 Macrolide versus placebo: children, Outcome 8 Azithromycin‐resistant Staphylococcus aureus.
Figuras y tablas -
Analysis 3.8

Comparison 3 Macrolide versus placebo: children, Outcome 8 Azithromycin‐resistant Staphylococcus aureus.

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Summary of findings for the main comparison. Macrolides compared with placebo for adults with bronchiectasis

Macrolides compared with placebo for adults with bronchiectasis

Patient or population: adults with bronchiectasis
Setting: outpatient clinics in Australia, Azerbaijan, Malaysia, Netherlands, New Zealand, and Thailand
Intervention: macrolides
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with placebo

Risk with macrolides

≥ 1 exacerbation
Follow‐up: range 24 weeks to 52 weeks

714 per 1000

459 per 1000
(355 to 574)

OR 0.34
(0.22 to 0.54)

341
(3 RCTs)

⊕⊕⊕⊝
MODERATEa

2 studies azithromycin (1750 mg/week for 52 weeks; 1500 mg/week for 6 months) 1 study erythromycin (3500 mg/week for 48 weeks)

Hospitalisation: all cause
Follow‐up: range 12 weeks to 52 weeks

133 per 1000

79 per 1000
(28 to 200)

OR 0.56
(0.19 to 1.62)

151
(2 RCTs)

⊕⊕⊝⊝
LOWb,c

2 studies azithromycin (1000 mg/week for 12 weeks; 1750 mg/week for 52 weeks)

Serious adverse events
Follow‐up: range 24 weeks to 48 weeks

86 per 1000

44 per 1000
(18 to 104)

OR 0.49
(0.20 to 1.23)

326
(3 RCTs)

⊕⊕⊝⊝
LOWb,d

2 studies azithromycin (1500 mg/week for 6 months; 1000 mg/week for 12 weeks) 1 study erythromycin (3500 mg/week for 48 weeks)

All‐cause mortality
Follow‐up: range 8 weeks to 52 weeks

0 per 1000

0 per 1000
(0 to 0)

not estimable

540
(7 RCTs)

⊕⊕⊝⊝
Lowe,f

4 studies azithromycin (1000 to 1750 mg/week for 12 to 52 weeks)
2 studies roxithromycin (2100 mg/week for 8 to 12 weeks)
1 study erythromycin (3500 mg/week for 48 weeks)

Quality of life: endpoint
assessed with SGRQ
Scale from 0 to 100
Follow‐up: 12 weeks

Mean SGRQ score at endpoint in placebo groups was 39.1 points.

MD 8.90 lower (13.13 lower to 4.67 lower)

‐

68
(1 RCTs)

⊕⊕⊕⊝
Moderateb

1 study azithromycin (1000 mg/week for 12 weeks)

Quality of life: change
assessed with SGRQ
Scale from 0 to 100
Follow‐up: range 8 weeks to 48 weeks

Mean change in SGRQ score ranged from ‐1.3 to ‐8.9 points.

MD 2.86 lower
(5.67 lower to 0.04 lower)

‐

305
(4 RCTs)

⊕⊕⊝⊝
LOWg,h

1 study azithromycin (1500 mg/week for 6 months)
1 study erythromycin (3500 mg/week for 48 weeks)
2 studies roxithromycin (2100 mg/week for 12 weeks; 2100 mg/week for 8 weeks)

*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; RR: risk ratio; SGRQ: St. George's Respiratory Questionnaire.

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.

aEffect observed only with azithromycin (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

bUnclear allocation concealment and baseline imbalances on Lourdesamy (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

cTwo small studies and wide confidence interval (one point deducted for imprecision).

dWide confidence interval (one point deducted for imprecision).

eIn three of the seven studies, study methods were not clearly reported (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

fA total of 28 participants across four studies were lost to follow‐up with no further details available and unclear details of withdrawals in one study (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

gRandomisation, blinding, and other study methods unclear in two studies (Asintam; Juthong) (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

hWide confidence interval and mean difference does not exceed the threshold for clinical significance (one point deducted for imprecision).

Figuras y tablas -
Summary of findings for the main comparison. Macrolides compared with placebo for adults with bronchiectasis
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Summary of findings 2. Macrolides compared with no intervention for adults with bronchiectasis

Macrolides compared with no intervention for adults with bronchiectasis

Patient or population: adults with bronchiectasis
Setting: outpatient clinics in China and Spain
Intervention: macrolides
Comparison: no intervention

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no intervention

Risk with macrolides

≥ 1 exacerbation
Follow‐up: 6 months

Study population

OR 0.31
(0.08 to 1.15)

43
(1 RCT)

⊕⊕⊕⊝
MODERATEa

Roxithromycin (1050 mg/week for 6 months)

762 per 1000

498 per 1000
(204 to 786)

Hospitalisations ‐ not reported

‐

‐

‐

‐

‐

Serious adverse events ‐ not reported

‐

‐

‐

‐

‐

Mortality
Follow‐up: range 3 months to 6 months

No deaths in two trials, although in 1 study (azithromycin), 6 participants were lost to follow‐up

not estimable

88
(2 RCTs)

⊕⊝⊝⊝
VERY LOWa,b,c

1 study azithromycin (750 mg/week for 3 months)
1 study roxithromycin (1050 mg/week for 6 months)

QoL SGRQ: endpoint total score
Scale from 0 to 100
Follow‐up: 6 months

Mean SGRQ: endpoint total score of 51.7 points

MD 8.81 lower (14.33 lower to 3.28 lower)

‐

89
(2 RCT)

⊕⊕⊕⊝
MODERATEa

1 study roxithromycin (1050 mg/week for 6 months)
1 study roxithromycin (1050 mg/week for 6 months)

QoL SGRQ: change in total score
Scale from 0 to 100
Follow‐up: 3 months

Mean SGRQ: change in total score of 4.1

MD 12 lower
(21.61 lower to 2.39 lower)

‐

30
(1 RCT)

⊕⊕⊕⊝
MODERATEa

Azithromycin (750 mg/week for 3 months)

*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; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio; OR: odds ratio; QoL: quality of life; SGRQ: St. George's Respiratory Questionnaire.

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.

aOpen‐label study (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

bUnclear randomisation and study methods (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

c6 participants in one study lost to follow‐up and no further details reported (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

Figuras y tablas -
Summary of findings 2. Macrolides compared with no intervention for adults with bronchiectasis
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Summary of findings 3. Macrolides compared with placebo for children with bronchiectasis

Macrolides compared with placebo for children with bronchiectasis

Patient or population: children with bronchiectasis
Setting: outpatient clinics in Australia, New Zealand, and South Africa
Intervention: macrolides
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with placebo

Risk with macrolides

Exacerbation frequency

Number of exacerbations 195 (median: 4 range 0‐14)

Number of exacerbations 104 (median: 2 range 0‐9)

IRR 0.50 95% CI 0.35 to 0.71

89
(1 RCT)

⊕⊕⊝⊝
LOWa,b

Azithromycin (30 mg/kg/week for up to 24 months)

Hospitalisation: all‐cause
Follow‐up: 24 months

205 per 1000

67 per 1000
(18 to 222)

OR 0.28
(0.07 to 1.11)

89
(1 RCT)

⊕⊕⊝⊝
LOWa,b

Azithromycin (30 mg/kg/week for 24 months)

Serious adverse events
Follow‐up: 24 months

432 per 1000

246 per 1000
(114 to 444)

OR 0.43
(0.17 to 1.05)

89
(1 RCT)

⊕⊕⊝⊝
LOWa,b

Azithromycin (30 mg/kg/week for 24 months)

Mortality

1 child died but study group was not stated.

‐

42
(1 RCT)

⊕⊕⊝⊝
LOWc,d

Erythromycin (875 to 1750 mg/kg/week for 52 weeks)

Quality of life not reported

‐

‐

‐

‐

‐

*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; IRR: incidence rate ratio; OR: odds ratio; RCT: randomised controlled trial; RR: risk ratio.

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.

aWide confidence interval that includes 1 (no difference) (one point deducted for imprecision).

bLow event rates and low numbers (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

cUnclear information on randomisation, blinding, and other study methods (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

dNo information on participants lost to follow‐up (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

Figuras y tablas -
Summary of findings 3. Macrolides compared with placebo for children with bronchiectasis
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Summary of findings 4. Macrolides compared with no intervention for children with bronchiectasis

Macrolides compared with no intervention for children with bronchiectasis

Patient or population: children with bronchiectasis
Setting: outpatient clinic in Turkey
Intervention: macrolides
Comparison: no intervention

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no intervention

Risk with macrolides

Exacerbations ‐ not reported

‐

‐

‐

‐

‐

Hospitalisation ‐ not reported

‐

‐

‐

‐

‐

Serious adverse events ‐ not reported

‐

‐

‐

‐

‐

Mortality
Follow‐up: 3 months

0 per 1000

0 per 1000
(0 to 0)

not estimable

34
(1 RCT)

⊕⊕⊝⊝
LOWa,b

Clarithromycin (105 mg/kg/week for 3 months)

Quality of life ‐ not reported

‐

‐

‐

‐

‐

*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; 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.

aInsufficient information on study methods and procedures (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

bNot blinded (one point deducted in relation to design and implementation of available studies suggesting likelihood of bias).

Figuras y tablas -
Summary of findings 4. Macrolides compared with no intervention for children with bronchiectasis
Ir a la tabla de la revisión
Table 1. Study characteristics

Study

Adults/

Children

No. of participants

Type of macrolide

Macrolide dose

Frequency

Delivery mode

Combined weekly dose

Comparison

Duration (months unless stated)

Altenburg 2013

Adults

83

Azithromycin

250 mg

Once daily

Oral

1750 mg

Placebo

12

Asintam 2012

Adults

30

Roxithromycin

300 mg

Once daily

Oral

2100 mg

Placebo

12 weeks

Cymbala 2005

Adults

12

Azithromycin

500 mg

3 days per week

Oral

1000 mg

No intervention

6

Diego 2013

Adults

36

Azithromycin

250 mg

3 days per week

Oral

750 mg

No intervention

3

Juthong 2011

Adults

26

Roxithromycin

300 mg

Once daily

Oral

2100 mg

Placebo

8 weeks

Koh 1997

Children

25

Roxithromycin

4 mg/kg

Twice daily

Oral

56 mg/kg

Placebo

12 weeks

Liu 2012

Adults

50

Roxithromycin, ambroxol hydrochloride

150 mg

Once daily

Oral

1050 mg

Ambroxol hydrochloride (no intervention)

6

Liu 2014

Adults

52

Roxithromycin

150 mg

Once daily

Oral

1050 mg

No intervention

6

Lourdesamy 2014

Adults

78

Azithromycin

1000 mg

Weekly

1000 mg

Placebo

3

Masekela 2013

Children

42

Erythromycin

125 mg for children weighing < 15 kg and 250 mg ≥ 15 kg

Daily

Oral

875 mg for children weighing < 15 kg and 1750 mg ≥ 15 kg

Placebo

12

Sadigov 2013

Adults

65

Azithromycin

500 mg

3 days per week

Oral

1500 mg

Placebo

6

Serisier 2013

Adults

117

Erythromycin

250 mg

Twice daily

Oral

3500 mg

Placebo

11

Valery 2013

Children

89

Azithromycin

30 mg/kg up to a maximum of 600 mg

Once a week

Oral

30 mg/kg up to a maximum of 600 mg

Placebo

24

Wong 2012

Adults

141

Azithromycin

500 mg

3 days per week

Oral

1500 mg

Placebo

6

Yalcin 2006

Children

34

Clarithromycin, supportive therapies

15 mg/kg

Daily

Oral

105 mg/kg

Supportive therapies (no intervention)

3
Figuras y tablas -
Table 1. Study characteristics
Ir a la tabla de la revisión
Comparison 1. Macrolide versus placebo: adults

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 ≥ 1 exacerbation Show forest plot

3

341

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.22, 0.54]

1.1 Azithromycin

2

224

Odds Ratio (M‐H, Fixed, 95% CI)

0.23 [0.13, 0.40]

1.2 Erythromycin

1

117

Odds Ratio (M‐H, Fixed, 95% CI)

0.74 [0.34, 1.63]

2 Hospitalisation: all‐cause Show forest plot

2

151

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.19, 1.62]

2.1 Azithromycin

2

151

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.19, 1.62]

3 Serious adverse events Show forest plot

3

326

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.20, 1.23]

3.1 Azithromycin

2

209

Odds Ratio (M‐H, Fixed, 95% CI)

0.51 [0.20, 1.34]

3.2 Erythromycin

1

117

Odds Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 8.07]

4 Sputum weight (g): endpoint Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 FEV1 (% predicted): endpoint Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 FEV1 (% predicted): change (post bronchodilator) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 Erythromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 FEV1 (L): endpoint Show forest plot

2

94

Mean Difference (IV, Fixed, 95% CI)

0.02 [‐0.17, 0.22]

7.1 Azithromycin

1

68

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.23, 0.21]

7.2 Roxithromycin

1

26

Mean Difference (IV, Fixed, 95% CI)

0.15 [‐0.27, 0.57]

8 FEV1 (L): change Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

8.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 FVC (% predicted): endpoint Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

9.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 FVC (L): endpoint Show forest plot

2

94

Mean Difference (IV, Fixed, 95% CI)

0.08 [‐0.19, 0.36]

10.1 Azithromycin

1

68

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.34, 0.30]

10.2 Roxithromycin

1

26

Mean Difference (IV, Fixed, 95% CI)

0.38 [‐0.16, 0.92]

11 FVC (L): change Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

11.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 FEV1/FVC: endpoint Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

12.1 Azithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Adverse events Show forest plot

5

435

Odds Ratio (M‐H, Fixed, 95% CI)

0.83 [0.51, 1.35]

13.1 Azithromycin

3

292

Odds Ratio (M‐H, Fixed, 95% CI)

0.77 [0.41, 1.45]

13.2 Erythromycin

1

117

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.51, 2.62]

13.3 Roxithromycin

1

26

Odds Ratio (M‐H, Fixed, 95% CI)

0.13 [0.01, 2.83]

14 Azithromycin‐resistant bacteria (any) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

14.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

15 6‐Minute walk test: change Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

15.1 Erythromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

16 Quality of life: endpoint Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐8.90 [‐13.13, ‐4.67]

16.1 Azithromycin

1

68

Mean Difference (IV, Fixed, 95% CI)

‐8.90 [‐13.13, ‐4.67]

17 Quality of life: change Show forest plot

4

305

Mean Difference (IV, Fixed, 95% CI)

‐2.86 [‐5.67, ‐0.04]

17.1 Azithromycin

1

141

Mean Difference (IV, Fixed, 95% CI)

‐3.25 [‐7.19, 0.69]

17.2 Erythromycin

1

117

Mean Difference (IV, Fixed, 95% CI)

‐2.60 [‐7.12, 1.92]

17.3 Roxithromycin

2

47

Mean Difference (IV, Fixed, 95% CI)

‐1.86 [‐10.63, 6.91]
Figuras y tablas -
Comparison 1. Macrolide versus placebo: adults
Ir a la tabla de la revisión
Comparison 2. Macrolide versus no intervention: adults

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 ≥ 1 exacerbation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Roxithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 QoL SGRQ: endpoint total score Show forest plot

2

89

Mean Difference (IV, Fixed, 95% CI)

‐8.81 [‐14.33, ‐3.28]

2.1 Roxithromycin

2

89

Mean Difference (IV, Fixed, 95% CI)

‐8.81 [‐14.33, ‐3.28]
Figuras y tablas -
Comparison 2. Macrolide versus no intervention: adults
Ir a la tabla de la revisión
Comparison 3. Macrolide versus placebo: children

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Hospitalisation: all‐cause Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Serious adverse events Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Sputum purulence score: endpoint Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 Roxithromycin

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 FEV1 (% predicted): endpoint Show forest plot

2

65

Mean Difference (IV, Fixed, 95% CI)

1.73 [‐3.32, 6.78]

4.1 Azithromycin

1

40

Mean Difference (IV, Fixed, 95% CI)

3.70 [‐5.99, 13.39]

4.2 Roxithromycin

1

25

Mean Difference (IV, Fixed, 95% CI)

1.0 [‐4.91, 6.91]

5 Adverse events Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Azithromycin‐resistant bacteria (any) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Azithromycin‐resistant Streptococcus pneumoniae Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Azithromycin‐resistant Staphylococcus aureus Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

8.1 Azithromycin

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. Macrolide versus placebo: children
Ir a la tabla de la revisión