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 pathogens, including 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.
To determine whether an empirical antibiotic treatment approach (used alone or in combination):
1. is effective for acute chest syndrome compared to placebo or standard treatment;
2. is safe for acute chest syndrome compared to placebo or standard treatment;
Further objectives are to determine whether there are important variations in efficacy and safety:
3. for different treatment regimens,
4. by participant age, or geographical location of the clinical trials.
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 15 September 2009) and the web site: www.clinicaltrials.gov (15 September 2009).
Date of most recent search of the Haemoglobinopathies Trials Register: 26 August 2009.
We searched for published or unpublished randomised controlled trials.
Data collection and analysis
Each author intended to independently extract data and assess trial quality by standard Cochrane Collaboration methodologies, but no eligible randomised controlled trials were identified.
We were unable to find any randomised controlled trials on antibiotic treatment approaches for acute chest syndrome in people with sickle cell disease.
This update was 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.