Examining the safety and efficacy of Azithromycin in Cystic fibrosis: A systematic review and Meta-analysis

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-06-17 DOI:10.1016/j.jiac.2025.102756

Aya Abd Elmegeed , Mariam A. Lotfy , Ahmed R. Abdullah , Esraa S.F. Sudan , Rania M. Mahmoud , Naglaa M. Marzuuk , Abdel-Karim Aljebeai , Muhammad M. Hassan , Syed Arman Rabbani , Gerrit Jacob , Pojsakorn Danpanichkul , Abdelrahman M. Attia

{"title":"Examining the safety and efficacy of Azithromycin in Cystic fibrosis: A systematic review and Meta-analysis","authors":"Aya Abd Elmegeed , Mariam A. Lotfy , Ahmed R. Abdullah , Esraa S.F. Sudan , Rania M. Mahmoud , Naglaa M. Marzuuk , Abdel-Karim Aljebeai , Muhammad M. Hassan , Syed Arman Rabbani , Gerrit Jacob , Pojsakorn Danpanichkul , Abdelrahman M. Attia","doi":"10.1016/j.jiac.2025.102756","DOIUrl":null,"url":null,"abstract":"<div><div>Cystic fibrosis (CF) patients experience chronic lung inflammation and decline. Azithromycin (AZM), a macrolide antibiotic, offers potential anti-inflammatory and antimicrobial benefits. We aim to evaluate the safety and efficacy of AZM therapy in patients with CF. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane on 22 December 2023. We included all relevant randomized controlled trials (RCTs) and cohort studies. Meta-analysis was conducted using R Studio software (version: 2023.12.1). Continuous outcomes were expressed as weighted mean differences with standard deviation (SD), and dichotomous variables were reported as relative risks with a 95 % confidence interval (CI). A total of 18 studies comprising 2877 patients were included, with 11 studies meeting the criteria for inclusion in the meta-analysis. AZM significantly reduced the need for new oral antibiotics (RR = 0.77; 95 % CI: [0.66, 0.89]). No significant increase in adverse events was observed. However, lung function (FEV1, FVC, FEF), inflammatory markers, and pulmonary exacerbations remained unchanged. Azithromycin holds promise for managing CF, but further research is needed to fully understand its long-term impact on lung health and resistance patterns.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102756"},"PeriodicalIF":1.5000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1341321X25001539","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Cystic fibrosis (CF) patients experience chronic lung inflammation and decline. Azithromycin (AZM), a macrolide antibiotic, offers potential anti-inflammatory and antimicrobial benefits. We aim to evaluate the safety and efficacy of AZM therapy in patients with CF. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane on 22 December 2023. We included all relevant randomized controlled trials (RCTs) and cohort studies. Meta-analysis was conducted using R Studio software (version: 2023.12.1). Continuous outcomes were expressed as weighted mean differences with standard deviation (SD), and dichotomous variables were reported as relative risks with a 95 % confidence interval (CI). A total of 18 studies comprising 2877 patients were included, with 11 studies meeting the criteria for inclusion in the meta-analysis. AZM significantly reduced the need for new oral antibiotics (RR = 0.77; 95 % CI: [0.66, 0.89]). No significant increase in adverse events was observed. However, lung function (FEV1, FVC, FEF), inflammatory markers, and pulmonary exacerbations remained unchanged. Azithromycin holds promise for managing CF, but further research is needed to fully understand its long-term impact on lung health and resistance patterns.

查看原文本刊更多论文

检查阿奇霉素治疗囊性纤维化的安全性和有效性：一项系统回顾和荟萃分析。

囊性纤维化（CF）患者经历慢性肺部炎症和衰退。阿奇霉素（AZM）是一种大环内酯类抗生素，具有潜在的抗炎和抗菌作用。我们的目标是评估AZM治疗CF患者的安全性和有效性。我们于2023年12月22日在PubMed、Scopus、Web of Science和Cochrane上进行了全面的检索。我们纳入了所有相关的随机对照试验（RCTs）和队列研究。meta分析采用R Studio软件（版本号：2023.12.1）进行。连续结果用加权平均标准差（SD）表示，二分类变量报告为相对风险，95%置信区间（CI）。共纳入18项研究，包括2877例患者，其中11项研究符合纳入meta分析的标准。AZM显著降低了对新型口服抗生素的需求(RR = 0.77；95% ci:[0.66, 0.89])。未观察到不良事件显著增加。然而，肺功能（FEV1， FVC， FEF），炎症标志物和肺恶化保持不变。阿奇霉素有望治疗CF，但需要进一步研究以充分了解其对肺部健康和耐药性模式的长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.