Clinical effect of azithromycin adjuvant therapy in children with bronchiolitis: a systematic review and Meta analysis

Abstract:

Objective To systematically evaluate the clinical effect of azithromycin (AZM) adjuvant therapy in children with bronchiolitis. Methods Related databases were searched for randomized controlled trials (RCTs) on AZM adjuvant therapy in children with bronchiolitis published up to February 17, 2019. RevMan 5.3 was used to perform the Meta analysis. Results A total of 14 RCTs were included, with 667 children in the intervention group and 651 in the control group. The pooled effect size showed that in the children with bronchiolitis, AZM adjuvant therapy did not shorten the length of hospital stay (MD=-0.29, 95%CI:-0.62 to 0.04, P=0.08) or oxygen supply time (MD=-0.33, 95%CI:-0.73 to 0.07, P=0.10), while it significantly shortened the time to the relief of wheezing (MD=-1.00, 95%CI:-1.72 to -0.28, P=0.007) and cough (MD=-0.48, 95%CI:-0.67 to -0.29, P < 0.00001). The analysis of bacterial colonization revealed that AZM therapy significantly reduced the detection rates of Streptococcus pneumoniae (OR=0.24, 95%CI:0.11-0.54, P=0.0006), Haemophilus (OR=0.28, 95%CI:0.14-0.55, P=0.0002), and Moraxella catarrhalis (OR=0.21, 95%CI:0.11-0.40, P < 0.00001) in the nasopharyngeal region. Conclusions AZM adjuvant therapy can reduce the time to the relief of wheezing and cough in children with bronchiolitis, but it has no marked effect on the length of hospital stay and oxygen supply time.