PMID- 34526011
OWN - NLM
STAT- MEDLINE
DCOM- 20220128
LR  - 20220128
IS  - 1465-993X (Electronic)
IS  - 1465-9921 (Print)
IS  - 1465-9921 (Linking)
VI  - 22
IP  - 1
DP  - 2021 Sep 15
TI  - The effect of additional antimicrobial therapy on the outcomes of patients with 
      idiopathic pulmonary fibrosis: a systematic review and meta-analysis.
PG  - 243
LID - 10.1186/s12931-021-01839-0 [doi]
LID - 243
AB  - BACKGROUND: The effect of additional antimicrobial agents on the clinical 
      outcomes of patients with idiopathic pulmonary fibrosis (IPF) is unclear. 
      METHODS: We performed comprehensive searches of randomized control trials (RCTs) 
      that compared the clinical efficacy of additional antimicrobial agents to those 
      of placebo or usual care in the treatment of IPF patients. The primary outcome 
      was all-cause mortality, and the secondary outcomes were changes in forced vital 
      capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), and 
      the risk of adverse events (AEs). RESULTS: Four RCTs including a total of 1055 
      patients (528 receiving additional antibiotics and 527 receiving placebo or usual 
      care) were included in this meta-analysis. Among the study group, 402 and 126 
      patients received co-trimoxazole and doxycycline, respectively. The all-cause 
      mortality rates were 15.0% (79/528) and 14.0% (74/527) in the patients who did 
      and did not receive additional antibiotics, respectively (odds ratio [OR] 1.07; 
      95% confidence interval [CI] 0.76 to 1.51; p = 0.71). No significant difference 
      was observed in the changes in FVC (mean difference [MD], 0.01; 95% CI - 0.03 to 
      0.05; p = 0.56) and DLCO (MD, 0.05; 95% CI - 0.17 to 0.28; p = 0.65). Additional 
      use of antimicrobial agents was also associated with an increased risk of AEs (OR 
      1.65; 95% CI 1.19 to 2.27; p = 0.002), especially gastrointestinal disorders (OR 
      1.54; 95% CI 1.10 to 2.15; p = 0.001). CONCLUSIONS: In patients with IPF, adding 
      antimicrobial therapy to usual care did not improve mortality or lung function 
      decline but increased gastrointestinal toxicity.
CI  - (c) 2021. The Author(s).
FAU - Chen, Ching-Yi
AU  - Chen CY
AD  - Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, 
      I-Shou University, Kaohsiung, Taiwan.
FAU - Chen, Chao-Hsien
AU  - Chen CH
AD  - Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, 
      Taipei, Taiwan.
AD  - Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
FAU - Wang, Cheng-Yi
AU  - Wang CY
AD  - Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, 
      College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
FAU - Lai, Chih-Cheng
AU  - Lai CC
AD  - Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan 
      Branch, Tainan, Taiwan.
FAU - Chao, Chien-Ming
AU  - Chao CM
AD  - Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, 
      Taiwan.
FAU - Wei, Yu-Feng
AU  - Wei YF
AUID- ORCID: 0000-0002-6380-3527
AD  - Department of Internal Medicine, E-Da Cancer Hospital, Yan-Chao District, No. 21, 
      Yida Road, Jiao-su Village, Kaohsiung, 824, Taiwan. yufeng528@gmail.com.
AD  - School of Medicine for International Students, College of Medicine, and Institute 
      of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan. 
      yufeng528@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210915
PL  - England
TA  - Respir Res
JT  - Respiratory research
JID - 101090633
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Anti-Infective Agents/*administration & dosage/*adverse effects
MH  - Drug Therapy, Combination/adverse effects
MH  - Gastrointestinal Diseases/chemically induced/diagnosis/mortality
MH  - Humans
MH  - Idiopathic Pulmonary Fibrosis/diagnosis/*drug therapy/*mortality
MH  - Mortality/trends
MH  - Randomized Controlled Trials as Topic/methods
MH  - Treatment Outcome
PMC - PMC8442344
OTO - NOTNLM
OT  - Antibiotic
OT  - Antimicrobial agent
OT  - Co-trimoxazole
OT  - Doxycycline
OT  - Idiopathic pulmonary fibrosis
OT  - Outcome
COIS- All authors (C.-Y. Chen., C.-H. Chen, C.-Y. Wang, C.-C. Lai, C.-M. Chao, and 
      Y.-F. Wei) have no conflicts of interest to disclose.
EDAT- 2021/09/17 06:00
MHDA- 2022/01/29 06:00
PMCR- 2021/09/15
CRDT- 2021/09/16 05:44
PHST- 2021/07/08 00:00 [received]
PHST- 2021/09/06 00:00 [accepted]
PHST- 2021/09/16 05:44 [entrez]
PHST- 2021/09/17 06:00 [pubmed]
PHST- 2022/01/29 06:00 [medline]
PHST- 2021/09/15 00:00 [pmc-release]
AID - 10.1186/s12931-021-01839-0 [pii]
AID - 1839 [pii]
AID - 10.1186/s12931-021-01839-0 [doi]
PST - epublish
SO  - Respir Res. 2021 Sep 15;22(1):243. doi: 10.1186/s12931-021-01839-0.