Meta-analyses and the evidence base for microbial outcomes in the treatment of pulmonary Mycobacterium avium-intracellulare complex disease

The Journal of Antimicrobial Chemotherapy
Jotam G PasipanodyaTawanda Gumbo

Abstract

To perform a systematic review and meta-analysis of the level of funding support and the sputum culture conversion rates in pulmonary Mycobacterium avium-intracellulare complex (P-MAC) disease in adult patients without cystic fibrosis or HIV infection, treated with recommended antibiotic regimens. We performed a literature search to identify clinical trials, prospective studies and registries that reported outcomes in P-MAC patients. Studies that reported P-MAC diagnosis and treatments based on established guidelines met the inclusion criteria and were examined for bias and quality. We modified existing quality scales and came up with a 10 star quality score. Outcomes meta-analysed were sputum conversion incidence ratios (IR) and their 95% CI, weighted for study quality. Twenty-one studies that examined 28 regimens, including 2534 patients in intent-to-treat analyses and 1968 in per-protocol analyses, were identified. The study quality mean ± SD scores were 5.4 ± 2.2 out of 10 stars. Only two (9.5%) studies received public funding. There was significant heterogeneity of microbial effect among treatment regimens (I2 > 40%; P > 0.001). The pooled IR for sustained sputum conversion was 0.54 (95% CI 0.45-0.63) for macrolide-contain...Continue Reading

References

May 1, 1994·American Journal of Respiratory and Critical Care Medicine·Richard J WallaceG H Mazurek
Jun 1, 1996·American Journal of Respiratory and Critical Care Medicine·Richard J WallaceD T Murphy
Nov 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David E GriffithRichard J Wallace
Sep 3, 1999·American Journal of Respiratory and Critical Care Medicine·E TanakaF Kuze
Sep 24, 1999·JAMA : the Journal of the American Medical Association·P JüniM Egger
Feb 15, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David E GriffithRichard J Wallace
May 8, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David E GriffithRichard J Wallace
May 26, 2004·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Mar 4, 2006·American Journal of Respiratory and Critical Care Medicine·Phung K LamAntonino Catanzaro
Feb 6, 2007·American Journal of Respiratory and Critical Care Medicine·David E GriffithInfectious Disease Society of America
May 5, 2010·Antimicrobial Agents and Chemotherapy·Jotam G Pasipanodya, Tawanda Gumbo
May 29, 2010·American Journal of Respiratory and Critical Care Medicine·Kevin L WinthropKatrina Hedberg
Jun 12, 2010·American Journal of Respiratory and Critical Care Medicine·D R PrevotsKenneth N Olivier
Sep 30, 2010·Yonsei Medical Journal·Yun Su SimWon Jung Koh
Apr 30, 2011·Future Microbiology·Devyani Deshpande, Tawanda Gumbo
Aug 27, 2011·Respiratory Medicine·Mauli Mehta, Theodore K Marras
Oct 1, 2011·Journal of Clinical Epidemiology·Meera Viswanathan, Nancy D Berkman
Apr 3, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jotam G PasipanodyaTawanda Gumbo
Aug 11, 2012·American Journal of Respiratory and Critical Care Medicine·Won Jung KohSung Jae Shin
Mar 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jotam G Pasipanodya, Tawanda Gumbo
May 17, 2013·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·K MaekawaM Mishima
Aug 28, 2013·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·H-B XuL Li
Oct 3, 2013·Annals of the American Thoracic Society·Theodore K MarrasPulmonary MAC Outcomes Group
Dec 5, 2013·Annals of the American Thoracic Society·Seiichi MiwaHiroshi Hayakawa
Nov 14, 2014·American Journal of Respiratory and Critical Care Medicine·Byeong-Ho JeongWon Jung Koh
Feb 28, 2015·Journal of Clinical Epidemiology·Nancy D BerkmanStephanie Chang
Jan 1, 2014·Archives of public health = Archives belges de santé publique·Victoria N NyagaMarc Aerts
Jun 13, 2015·American Journal of Respiratory and Critical Care Medicine·David E GriffithRichard J Wallace
Jan 27, 2016·Antimicrobial Agents and Chemotherapy·Devyani DeshpandeTawanda Gumbo
Apr 17, 2016·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·M FleshnerD R Prevots
Oct 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Tawanda GumboJames A Seddon
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Devyani DeshpandeTawanda Gumbo
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Devyani DeshpandeTawanda Gumbo
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Devyani DeshpandeTawanda Gumbo

Citations

Apr 18, 2018·Antimicrobial Agents and Chemotherapy·Byung Woo JhunWon Jung Koh
Jun 8, 2018·American Journal of Respiratory and Critical Care Medicine·Byung Woo JhunWon Jung Koh
Jul 3, 2019·Antimicrobial Agents and Chemotherapy·Mike Marvin RuthJakko van Ingen
Jul 7, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Charles L DaleyKevin L Winthrop
Aug 14, 2020·Deutsche medizinische Wochenschrift·D Wagner, C Lange
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Devyani DeshpandeTawanda Gumbo
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Jan-Willem C Alffenaar, Jakko van Ingen
Jul 2, 2019·Expert Review of Respiratory Medicine·Yong-Soo KwonWon-Jung Koh
Dec 23, 2018·Tuberculosis and Respiratory Diseases·Yong Soo KwonCharles L Daley
Jan 29, 2020·Expert Review of Anti-infective Therapy·Mohammad Javad NasiriMehdi Mirsaeidi
Sep 20, 2017·The Journal of Antimicrobial Chemotherapy·Devyani DeshpandeTawanda Gumbo
May 22, 2019·Open Forum Infectious Diseases·Takanori AsakuraNaoki Hasegawa
Sep 3, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Keiji FujiwaraKozo Morimoto
Oct 28, 2020·The Indian Journal of Medical Research·Surendra K Sharma, Vishwanath Upadhyay

Related Concepts

Related Feeds

Alternative Complement Pathway

The Alternative Complement Pathway is part of the innate immune system, and activation generates membrane attack complexes that kill pathogenic cells. Discover the latest research on the Alternative Complement Pathway.