SynthesisBMC pulmonary medicine2026
Inhaled tobramycin for chronic pseudomonas aeruginosa infection in non-cystic fibrosis bronchiectasis: an updated systematic review and meta-analysis.
Synthesis in BMC pulmonary medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Factors governing the response ofFrontiers in cellular and infection microbiology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveTo evaluate the efficacy and safety of inhaled tobramycin for the treatment of chronic Pseudomonas aeruginosa infection in adult patients with non-cystic fibrosis (NCF) bronchiectasis.
methodA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched up to January 18, 2026. The search strategy incorporated Medical Subject Headings (MeSH) terms and free-text synonyms combined with Boolean operators. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Parallel-group RCTs comparing inhaled tobramycin with placebo or no treatment in adults with NCF bronchiectasis and chronic P. aeruginosa infection were included.
resultsTen RCTs were included. Inhaled tobramycin was associated with a significantly higher rate of P. aeruginosa eradication (Odds Ratio [OR] 5.04, 95% CI 1.80–14.09) and a greater reduction in sputum bacterial density (Weighted Mean Difference [WMD] -2.87 log₁₀ CFU/g, 95% CI -4.21 to -1.52). Treatment with tobramycin significantly reduced the number of hospital admissions (WMD − 0.45, 95% CI -0.68 to -0.22) and the total days of hospital admission (WMD − 11.73, 95% CI -18.81 to -4.65). No significant improvement in FEV₁% predicted or the overall frequency of exacerbations was found. The incidence of non-fatal adverse events was similar between groups, with a non-significant trend towards increased tobramycin resistance. Sensitivity analyses, including leave-one-out analysis and exclusion of older studies, were performed to explore sources of heterogeneity. The GRADE assessment indicated that the certainty of evidence ranged from very low to moderate across outcomes.
conclusionIn patients with NCF bronchiectasis and chronic P. aeruginosa infection, inhaled tobramycin effectively improves microbiological outcomes and appears to reduce the frequency and duration of hospitalizations, although the latter finding is based on limited data (three studies, n = 90) and should be interpreted with caution. While it does not improve lung function or overall exacerbation rates, its safety profile is acceptable. The overall certainty of evidence, as assessed by the GRADE framework, ranges from very low to moderate, underscoring the need for large-scale, long-term RCTs to confirm these findings.
trial registrationPROSPERO(CRD420261294797).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.