Antibiotics for treating acute chest syndrome in people with sickle cell disease.
BACKGROUND
The 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.


OBJECTIVE
To 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.


METHODS
We 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: http://www.clinicaltrials.gov (May 2006). Date of most recent search of the Haemoglobinopathies Trials Register: February 2007.


METHODS
We searched for published or unpublished randomised controlled trials.


METHODS
Each author intended to independently extract data and assess trial quality by standard Cochrane Collaboration methodologies, but no eligible randomized controlled trials were identified.


RESULTS
We were unable to find any randomised controlled trials on antibiotic treatment approaches for acute chest syndrome in people with sickle cell disease.


CONCLUSIONS
We 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.
Martí-Carvajal
A J
AJ
Universidad de Carabobo, Departamento de Salud Pública, Centro Colaborador Venezolano de la Red Iberoamericana de la Colaboración Cochrane, Valencia, Edo. Carabobo, Venezuela, 2001. amarti@uc.edu.ve
Conterno
L O
LO
Knight-Madden
J M
JM
D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003371:Cough / Q000188:drug therapy; D005334:Fever / Q000188:drug therapy*; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy*; D012120:Respiration Disorders / Q000188:drug therapy* / Q000382:microbiology; D013183:Sputum / Q000378:metabolism; D013577:Syndrome
D000900:Anti-Bacterial Agents