International Journal of COPD (Aug 2017)
Network meta-analysis of success rate and safety in antibiotic treatments of bronchitis
Abstract
Jinghua Wang,1 Haiyang Xu,2 Pan Liu,3 Mingxian Li4 1Pediatric of Rheumatology, Immunology and Allergy, The First Hospital of Jilin University, Changchun, 2Department of Anesthesiology, The First Hospital of Jilin University, Changchun, 3Department of Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 4Department of Respiratory, The First Hospital of Jilin University, Changchun, China Abstract: The purpose of this study was to compare the relative efficacy and safety of different antibiotic drugs and recommend superior regimens in the treatment of bronchitis. With respect to the antibiotic comparisons against quinolones in terms of intention-to-treat patients, we concluded that quinolones had advantages over placebo, β-lactams, sulfonamides, and double β-lactams. Concerning treatment methods for clinically evaluable patients, quinolones demonstrated better performance than β-lactams and sulfonamides. The secondary effects of macrolides, quinolones, and double β-lactams were significantly more adverse than β-lactams with odds ratios (ORs) of 1.5 (95% credible interval [CrI] =1.1–2.0), 1.7 (95% CrI =1.2–2.3), and 2.7 (95% CrI =1.8–4.1), respectively. Significant differences in the prevalence of diarrhea as a secondary effect were only identified among the comparisons of double β-lactams against β-lactams and macrolides (OR =5.0, 95% CrI =2.1–12.0; OR =3.0, 95% CrI =1.7–5.4, respectively). Quinolones can be recommended as the superior treatment for bronchitis, in accordance with our cluster analysis with surface under the cumulative ranking curve. The primary outcomes of network meta-analysis indicated that quinolones showed the best performance among the 8 treatments studied, although β-lactams showed the lowest risk of adverse side effects. Quinolones are recommended as the primary treatment option for bronchitis patients, having taking into account the success rates and safety profiles of the eight drugs studied here. Keywords: bronchitis, antibiotic treatments, success rate, safety, network meta-analysis
