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Azithromycin for the Treatment of Obliterative Bronchiolitis after Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis.
- Source :
-
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2016 Dec; Vol. 22 (12), pp. 2264-2269. Date of Electronic Publication: 2016 Aug 26. - Publication Year :
- 2016
-
Abstract
- Obliterative bronchiolitis (OB) is a major cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). Our objective was to perform a systematic review and meta-analysis of the impact of azithromycin on change in forced expiratory volume in 1 second (FEV <subscript>1</subscript> ). We searched MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL and Scopus databases and included studies that compared azithromycin with placebo or no intervention in the treatment of OB or bronchiolitis obliterans syndrome (BOS) in patients who had undergone allogeneic HSCT. Ninety-one unique publications were identified, and 4 studies met inclusion criteria, with a total of 90 patients. Changes in FEV <subscript>1</subscript> were measured between 12 and 24 weeks after initiation of treatment. The meta-analysis demonstrated a mean increase in FEV <subscript>1</subscript> of 30 mL (95% confidence interval, -260 to +330 mL; P = .82) after initiation of azithromycin. One patient death was reported but not attributed to azithromycin therapy. In conclusion, current evidence can neither support nor refute the use of azithromycin in the treatment of patients who develop OB/BOS after HSCT. Further studies are needed to determine whether azithromycin is beneficial for the treatment of OB/BOS in this setting.<br />Competing Interests: None<br /> (Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Azithromycin pharmacology
Bronchiolitis Obliterans etiology
Forced Expiratory Volume drug effects
Humans
Treatment Outcome
Azithromycin therapeutic use
Bronchiolitis Obliterans drug therapy
Hematopoietic Stem Cell Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 22
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 27575542
- Full Text :
- https://doi.org/10.1016/j.bbmt.2016.08.027