PMID- 31939108
OWN - NLM
STAT- MEDLINE
DCOM- 20200626
LR  - 20200626
IS  - 1179-2019 (Electronic)
IS  - 1174-5878 (Linking)
VI  - 22
IP  - 2
DP  - 2020 Apr
TI  - Efficacy of Macrolides on Acute Asthma or Wheezing Exacerbations in Children with 
      Recurrent Wheezing: A Systematic Review and Meta-analysis.
PG  - 217-228
LID - 10.1007/s40272-019-00371-5 [doi]
AB  - INTRODUCTION: The role of macrolides for treatment of children with acute asthma 
      or wheezing exacerbations is unclear. OBJECTIVE: The aim of this systematic 
      review was to evaluate the effectiveness of macrolides in children with recurrent 
      wheezing presenting with acute asthma or wheezing exacerbation. METHODS: We 
      conducted an electronic search in MEDLINE, EMBASE, CINAHL, LILACS, CENTRAL, and 
      ClinicalTrials.gov. STUDY SELECTION CRITERIA: Randomized controlled trials of 
      macrolides (any macrolide) compared with placebo or standard treatment in 
      children up to 18 years with recurrent wheezing/asthma presenting with an acute 
      exacerbation. OUTCOMES: Primary outcomes were need for hospitalization and/or 
      time of acute asthma/wheezing symptoms resolution; secondary outcomes were 
      duration of stay in the emergency department (ED)/clinic, severity of symptoms of 
      the index episode, use of additional systemic corticosteroids or short active beta-2 
      agonists, changes in lung function measures, ED visit/hospitalization during 
      first week after index episode, time to next exacerbation, or adverse effects 
      (AEs). RESULTS: Only three studies met the inclusion criteria (n = 334 children, 
      410 treated episodes); two studies included recurrent wheezers and the third 
      included asthmatic children. There was no difference in hospitalization between 
      groups, but children treated with macrolides had a significantly lower time to 
      symptoms resolution than controls, although the magnitude of benefit remains to 
      be quantified due to no normal distribution data presented. There was no 
      difference in time to next episode of exacerbation (HR 0.96; 95% CI 0.71-1.28; 
      I(2) = 0%; p = 0.77). In one study, children receiving macrolides had a 
      significant decrease in the severity of symptoms, decrease use of salbutamol, and 
      another study showed improved lung function. No study evaluated antibiotic 
      resistance development. CONCLUSIONS: Limited evidence support that a macrolide 
      trial could be considered in children with acute asthma or recurrent wheezing 
      exacerbation.
FAU - Pincheira, Mauricio A
AU  - Pincheira MA
AD  - Division of Pediatrics, Department of Pediatric Pulmonology and Cardiology, 
      School of Medicine, Pontificia Universidad Catolica de Chile, Lira 44, 1er Piso, 
      casilla 114-D, Santiago, Chile.
FAU - Bacharier, Leonard B
AU  - Bacharier LB
AD  - Department of Pediatrics, Washington University School of Medicine and St. Louis 
      Children's Hospital, St. Louis, MO, USA.
FAU - Castro-Rodriguez, Jose A
AU  - Castro-Rodriguez JA
AUID- ORCID: 0000-0002-0708-4281
AD  - Division of Pediatrics, Department of Pediatric Pulmonology and Cardiology, 
      School of Medicine, Pontificia Universidad Catolica de Chile, Lira 44, 1er Piso, 
      casilla 114-D, Santiago, Chile. jacastro17@homail.com.
LA  - eng
GR  - 170925013/Fondo de Fomento al Desarrollo Cientifico y Tecnologico/International
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - Switzerland
TA  - Paediatr Drugs
JT  - Paediatric drugs
JID - 100883685
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Macrolides)
SB  - IM
EIN - Paediatr Drugs. 2020 Mar 13;:. PMID: 32166730
MH  - Acute Disease
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Anti-Asthmatic Agents/pharmacology/*therapeutic use
MH  - Anti-Bacterial Agents/pharmacology/*therapeutic use
MH  - Asthma/*drug therapy
MH  - Child
MH  - Humans
MH  - Macrolides/pharmacology/*therapeutic use
MH  - Respiratory Sounds/*drug effects
EDAT- 2020/01/16 06:00
MHDA- 2020/06/27 06:00
CRDT- 2020/01/16 06:00
PHST- 2020/01/16 06:00 [pubmed]
PHST- 2020/06/27 06:00 [medline]
PHST- 2020/01/16 06:00 [entrez]
AID - 10.1007/s40272-019-00371-5 [pii]
AID - 10.1007/s40272-019-00371-5 [doi]
PST - ppublish
SO  - Paediatr Drugs. 2020 Apr;22(2):217-228. doi: 10.1007/s40272-019-00371-5.