Mucolytics for bronchiectasisreview
Аннотация: Background Bronchiectasis is predominantly an acquired disease process representing the end stage of a variety of unrelated pulmonary insults. It is defined as a persistent irreversible dilatation and distortion of medium‐sized bronchi. Patients diagnosed with bronchiectasis frequently have difficulty expectorating the infected sputum. Mucolytic agents target hyper‐secretion or changed physiochemical properties of sputum to make it easier to clear. One drug, recombinant human DNase, breaks down the DNA that is released at the site of infection by neutrophils. Objectives The objective of this review was to assess the effects of ingested or inhaled mucolytics in people with bronchiectasis. Search methods We searched the Cochrane Airways Group Specialised Register and reference lists of relevant articles. We also contacted experts in the field and drug companies. Searches were current as of January 2010. Selection criteria Randomised trials of mucolytic treatment in people with bronchiectasis but not cystic fibrosis. Data collection and analysis Data extraction was performed independently by two reviewers. Study authors were contacted for confirmation. Main results Three trials were included, but none of their data could be aggregated in a meta analysis. Compared to placebo, high doses of bromhexine with antibiotics eased difficulty in expectoration (weighted mean difference ‐0.53, 95% confidence interval ‐0.81 to ‐0.25 at 16 days). There was also a reduction in sputum production with bromhexine (weighted mean difference ‐21.5%, 95% confidence interval ‐38.9 to ‐4.1 % at day 16). Compared to placebo, recombinant human DNase showed no difference in forced expiratory volume or forced vital capacity in one study and was reported to have a significant negative effect on forced expiratory volume in another study. Adverse effects, including influenza‐like symptoms, were more common in the group receiving recombinant human DNase. An update search conducted in January 2010 did not yield any further studies for inclusion in the review. Authors' conclusions There is not enough evidence to evaluate the routine use of mucolytics for bronchiectasis. High doses of bromhexine coupled with antibiotics may help with sputum production and clearance.
Год издания: 2001
Издательство: Cochrane
Источник: Cochrane database of systematic reviews
Ключевые слова: Cystic Fibrosis Research Advances, Neonatal Respiratory Health Research, Tracheal and airway disorders
Другие ссылки: Cochrane database of systematic reviews (HTML)
UniSA Research Outputs Repository (University of South Australia) (HTML)
PubMed (HTML)
UniSA Research Outputs Repository (University of South Australia) (HTML)
PubMed (HTML)
Открытый доступ: closed