Oral versus inhaled antibiotics for bronchiectasis.

Area of Science:

• Pulmonology
• Infectious Diseases
• Clinical Trials

Background:

• Bronchiectasis is a chronic lung disease characterized by recurrent bacterial infections, cough, and reduced quality of life.
• Antibiotics are the primary treatment for bronchiectasis exacerbations.
• Inhaled antibiotics may offer better eradication and lower resistance risk than oral antibiotics, but direct comparisons are lacking.

Purpose of the Study:

• To compare the efficacy and safety of oral versus inhaled antibiotics in treating adults and children with bronchiectasis.
• To synthesize existing evidence on antibiotic treatment strategies for bronchiectasis.

Main Methods:

• Systematic search of multiple databases (CENTRAL, MEDLINE, Embase, etc.) and trial registers.
• Inclusion criteria focused on studies comparing oral and inhaled antibiotics in bronchiectasis patients, excluding specific conditions like cystic fibrosis.
• Data extraction, risk of bias assessment, and quality evaluation using GRADE criteria were planned.

Main Results:

• A comprehensive search identified 334 unique records.
• After screening titles, abstracts, and full-text reports, no studies met the inclusion criteria for the review.
• Consequently, no data could be extracted or analyzed.

Conclusions:

• There is currently no evidence to support the superiority of oral over inhaled antibiotics for bronchiectasis.
• New research is essential to compare inhaled versus oral antibiotic therapies in patients with frequent exacerbations.
• Future studies should evaluate effectiveness in exacerbation prevention, quality of life, treatment burden, and antibiotic resistance.