Additional Relevant Details
Utilizing a systematic literature search, the network meta-analyses leveraged data from all randomized clinical trials of inhaled antibiotics in CF patients with at least 4 or 24 weeks of follow-up, and compared the effect of inhaled antibiotics tobramycin, colistimethate sodium, aztreonam and levofloxacin against P. aeruginosa infections. Of the 685 articles identified, 7 and 9 unique studies were included in the 4 weeks and 24 weeks analysis, respectively.Aztreonam, dosed at 75 mg three times daily, was predicted to result in the greatest numerical increase in forced expiratory volume in 1 second (FEV1%) at 4 weeks, while levofloxacin inhalation solution was predicted to be numerically greater than colistimethate sodium, tobramycin inhaled solution and tobramycin inhaled powder. The analyses for many of the outcomes did not provide evidence to indicate that the other treatments were more effective than levofloxacin. At 24 weeks, levofloxacin inhalation solution was associated with the lowest risk of hospitalization with a 96.5% of probability to be the best treatment. P. aeruginosa sputum density scores, additional antipseudomonal antibiotics use, and study withdrawal rates were comparable among all inhaled antibiotics at all times.