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Antibiotics for treating acute chest syndrome in people with sickle cell diseaseMartí-Carvajal AJ, Conterno LO, Knight-Madden JM
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SummaryAntibiotics for treating acute chest syndrome in people with sickle cell diseaseSickle cell disease affects millions of people throughout the world. Acute chest syndrome is a major cause of illness and death in people with sickle cell disease. Symptoms include fever, chest pain and a raised white blood cell count. Acute infection of the lung tissue is a major cause of acute chest syndrome. Antibiotics are often given to treat these lung infections, but there is no worldwide standard treatment. We searched for randomized controlled trials which compared antibiotics (alone or in combination) with other antibiotics, placebo or standard treatment. We wanted to know if the different antibiotic treatments were effective, if they were safe, and which doses worked best for acute chest syndrome in people with sickle cell disease. We did not find any trials to include in this review. We conclude that a randomized controlled trial should attempt to answer these questions. Until there is firm evidence, clinicians should treat acute chest syndrome on a case by case basis and according to the diagnosis and the treatment available.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 18. 2007 AbstractBackgroundThe clinical presentation of acute chest syndrome is similar whether due to infectious or non-infectious causes, thus antibiotics are usually prescribed to treat all episodes. Many different bacteria have been implicated as causative agents of acute chest syndrome. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different antibiotic treatment approaches for people with sickle cell disease suffering from acute chest syndrome. ObjectivesTo determine whether an empirical antibiotic treatment approach (used either alone or in combination): (a) is effective in treating acute chest syndrome compared to placebo or standard treatment; (b) is safe in treating acute chest syndrome compared to placebo or standard treatment; (c) differs dependent on the regimen used in treating acute chest syndrome differ from each other with respect to efficacy and safety; and (d) varies between different age groups, regions or countries with respect to efficacy and safety. Search strategyWe searched The Group's Haemoglobinopathies Trials Register, which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also searched the LILACS database (1982 to May 2006) and the website: www.clinicaltrials.gov (May 2006). Date of most recent search of the Haemoglobinopathies Trials Register: November 2007. Selection criteriaWe searched for published or unpublished randomised controlled trials. Data collection and analysisEach author intended to independently extract data and assess trial quality by standard Cochrane Collaboration methodologies, but no eligible randomized controlled trials were identified. Main resultsWe were unable to find any randomised controlled trials on antibiotic treatment approaches for acute chest syndrome in people with sickle cell disease. Authors' conclusionsWe were unable to identify randomised controlled trials on efficacy and safety of the antibiotic treatment approaches for people with sickle cell disease suffering from acute chest syndrome. Randomised controlled trials are needed to establish the optimum antibiotic treatment for this condition. |