Short Acting Beta-2 Agonists for Bronchiectasis

Background: Bronchiectasis is a condition characterized by an abnormal and irreversible dilatation of the sub segmental airways and it may be caused by a variety of disease processes. Currently medical treatment includes physiotherapy, antibiotics and occasionally mucolytics. Many people with bronchiectasis receive bronchodilator therapy, since many people with the condition show signs of airflow obstruction and bronchial hyper-responsiveness. Evidence on effectiveness of bronchodilator therapy in bronchiectasis has only recently started to be systematically studied.

Objectives: The present review examined the effectiveness of short acting beta-2 agonist therapy in bronchiectasis, as this is the most frequently used treatment for airflow obstruction in people with this condition.

Search Strategy: We systematically searched four databases: CENTRAL (Issue 2, 2002); MEDLINE (1966 to September 2002); EMBASE (1980 to September 2002); and CINAHL (1982 to September 2002). We also checked bibliographies of all identified RCTs to identify potentially relevant citations.

Selection Criteria: All randomised controlled trials were considered for inclusion, whether single or double blind. The control group was placebo/no treatment or other drug/physical therapy. Participants could be children or adults diagnosed with bronchiectasis by plain-film chest radiograph, bronchography or high resolution computerized tomography. Patients were excluded if they had cystic fibrosis. Any type of short acting beta-2 agonist administered by inhalation or systemic route, used in conjunction with conventional treatment was included.

Data Collection And Analysis: In the absence of any relevant RCTs, we were unable to extract or analyse data.

Main Results: We identified 48 articles by the search, the majority of which could be excluded on the basis of the abstract as they were not RCTs. Six articles were retrieved and were all excluded after careful consideration because they were either not RCTs or they did not deal with the question of interest.

Reviewer's Conclusions: We failed to identify any RCTs investigating the role of short acting beta agonists in bronchiectasis. Since short acting beta-2 agonist therapy is the most frequently used treatment for airflow obstruction in bronchiectasis, there appears to be the need to investigate the effectiveness of this therapy using an RCT.