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

Si-Yi Che1, Huan He, Yu Deng

  • 1Department of Respiratory, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. emliu186@126.com.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|August 17, 2019
PubMed

Insights

Azithromycin (AZM) adjuvant therapy for pediatric bronchiolitis effectively reduces wheezing and cough duration. However, this meta-analysis found no significant impact on hospital stay or oxygen needs.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Bronchiolitis is a common viral respiratory infection in infants and young children.
  • Bacterial co-infections can complicate bronchiolitis, potentially influencing treatment outcomes.
  • Azithromycin (AZM), a macrolide antibiotic, has immunomodulatory and antimicrobial properties.

Purpose of the Study:

  • To systematically evaluate the clinical efficacy of azithromycin (AZM) as an adjuvant therapy in children diagnosed with bronchiolitis.
  • To assess AZM's impact on symptom duration, hospital stay, and oxygen requirements.
  • To investigate AZM's effect on bacterial colonization in the nasopharynx of children with bronchiolitis.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
  • Searched major databases for RCTs on AZM adjuvant therapy for pediatric bronchiolitis up to February 17, 2019.
  • Meta-analysis performed using RevMan 5.3, including 14 RCTs with 667 children in the intervention group and 651 in the control group.

Main Results:

  • AZM adjuvant therapy did not significantly shorten hospital stay (MD=-0.29, P=0.08) or oxygen supply time (MD=-0.33, P=0.10).
  • Significant reductions were observed in the time to relief of wheezing (MD=-1.00, P=0.007) and cough (MD=-0.48, P<0.00001).
  • AZM therapy significantly decreased the detection rates of Streptococcus pneumoniae, Haemophilus, and Moraxella catarrhalis in the nasopharynx.

Conclusions:

  • Azithromycin adjuvant therapy is effective in reducing the duration of wheezing and cough in pediatric patients with bronchiolitis.
  • AZM does not appear to significantly affect the length of hospital stay or the need for oxygen therapy.
  • AZM may play a role in reducing bacterial colonization in the respiratory tract of children with bronchiolitis.
Abstract

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