Interventions for bronchiectasis: an overview of Cochrane systematic reviews
Review gives starting point in reducing uncertainly in treating chronic wet coughs.
Bronchiectasis is a long-term respiratory disease characterized by abnormal dilatation of the bronchi; it is commonly associated with a troublesome cough with mucous or chronic wet cough in children. There are often recurrent flare-ups due to lung infections. It significantly impacts upon normal daily activities and quality of life, and can lead to recurrent hospitalizations, loss of lung function, and even death.
A team of Cochrane authors based in the United Kingdom worked with Cochrane Airways to provide an overview of interventions for adults and children with bronchiectasis from Cochrane Reviews. They also sought to identify gaps in the evidence to inform recommendations for new research.
The overview assesses 21 Cochrane Reviews, but authors extracted data from only nine reviews that reported results for people with bronchiectasis alone. The included reviews were of high quality.
It was not possible to draw definitive conclusions due to inconclusive and limited evidence. While the reviews included were of high quality, some are in need of updating with new evidence. The majority of the trials were small in size. The overall coverage of important topics in bronchiectasis was evaluated by mapping the quality of the current evidence base against published guidelines. High-priority areas for new research identified were: the use of short-course and long-term antibiotics, ICS and oral corticosteroids, inhaled hyperosmolars, mucolytics, and use of airway clearance techniques.
“There are relatively few trials and Cochrane Reviews available so it is difficult to draw helpful conclusions about how to treat bronchiectasis,” said Emma Welsh, a researcher at St George’s University of London in the United Kingdom and lead author of the Cochrane Review. “This overview Cochrane Review offers important insight on how research on bronchiectasis can move forward and can address the gaps in knowledge.”