Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2012
ReviewWITHDRAWN: Opioids for the palliation of breathlessness in advanced disease and terminal illness.
Breathlessness is a common symptom in people with advanced disease. The most effective treatments are aimed at treating the underlying cause of the breathlessness but this may not be possible and symptomatic treatment is often necessary. Strategies for the symptomatic treatment of breathlessness have never been systematically evaluated. Opioids are commonly used to treat breathlessness: the mechanisms underlying their effectiveness are not completely clear and there have been few good-sized trials in this area. ⋯ There is evidence to support the use of oral or parenteral opioids to palliate breathlessness although numbers of patients involved in the studies were small. No evidence was found to support the use of nebulised opioids. Further research with larger numbers of patients, using standardised protocols and with quality of life measures is needed.
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Cochrane Db Syst Rev · Jul 2012
ReviewElective versus symptomatic intravenous antibiotic therapy for cystic fibrosis.
Pseudomonas aeruginosa is the commonest micro-organism associated with respiratory infections in cystic fibrosis. Retrospective studies have suggested that using an aggressive policy of intravenous anti-pseudomonal antibiotics at regular intervals, irrespective of symptoms, increases survival. ⋯ Studies are insufficient to identify conclusive evidence favouring a policy of elective intravenous antibiotic administration, despite its widespread use, neither are the potential risks adequately evaluated. The results should be viewed with caution, as participant numbers are small. Clearly there is a need for a well-designed, adequately-powered, multicentred randomised controlled trial to evaluate these issues.