PMID- 37237074
OWN - NLM
STAT- MEDLINE
DCOM- 20231106
LR  - 20231213
IS  - 1530-0447 (Electronic)
IS  - 0031-3998 (Linking)
VI  - 94
IP  - 5
DP  - 2023 Nov
TI  - Efficacy and safety of macrolides in the treatment of children with 
      bronchiectasis: a meta-analysis.
PG  - 1600-1608
LID - 10.1038/s41390-023-02591-5 [doi]
AB  - BACKGROUND: This study summarized the available randomized controlled trials 
      (RCTs) to assess the efficacy and safety of macrolides on pathogens, lung 
      function, laboratory parameters, and safety in children with bronchiectasis. 
      METHODS: PubMed, EMBASE, and the Cochrane Library were searched for available 
      papers published up to June 2021. The outcomes were the pathogens, adverse events 
      (AEs), and the forced expiratory volume in one second (FEV1%) predicted. RESULTS: 
      Seven RCTs (633 participants) were included. The long-term use of macrolides 
      reduced the risk of the presence of Moraxella catarrhalis (RR = 0.67, 95% CI: 
      0.30-1.50, P = 0.001; I(2) = 0.0%, P(heterogeneity) = 0.433), but not Haemophilus 
      influenza (RR = 0.19, 95% CI: 0.08-0.49, P = 0.333; I(2) = 57.0%, 
      P(heterogeneity) = 0.040), Streptococcus pneumonia (RR = 0.91, 95% CI: 0.61-1.35, 
      P = 0.635; I(2) = 0.0%, P(heterogeneity) = 0.515), Staphylococcus aureus 
      (RR = 1.01, 95% CI: 0.36-2.84, P = 0.986; I(2) = 61.9%, 
      P(heterogeneity) = 0.033), and any pathogens present (RR = 0.61, 95% CI: 
      0.29-1.29, P = 0.195; I(2) = 80.3%, P(heterogeneity) = 0.006). Long-term 
      macrolides had no effect on FEV1% predicted (WMD = 2.61, 95% CI: -1.31, 6.53, 
      P = 0.192; I(2) = 0.0%, P(heterogeneity) = 0.896). Long-term macrolides did not 
      increase the risk of AEs or serious AEs. CONCLUSION: Macrolides do not 
      significantly reduce the risk of pathogens present (except for Moraxella 
      catarrhalis) or increase FEV1% predicted among children with bronchiectasis. 
      Moreover, macrolides were not associated with AEs. Considering the limitations of 
      the meta-analysis, further larger-scale RCTs are needed to confirm the findings. 
      IMPACT: Macrolides do not significantly reduce the risk of pathogens present 
      (except for Moraxella catarrhalis) among children with bronchiectasis. Macrolides 
      do not significantly increase FEV1% predicted among children with bronchiectasis. 
      This meta-analysis reports on the efficacy and safety of macrolides in the 
      treatment of children with bronchiectasis, providing evidence for the management 
      of children with bronchiectasis. This meta-analysis does not support the use of 
      macrolides in the management of children with bronchiectasis unless the presence 
      of Moraxella catarrhalis is provenor suspected.
CI  - (c) 2023. The Author(s), under exclusive licence to the International Pediatric 
      Research Foundation, Inc.
FAU - Song, Guihua
AU  - Song G
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China. 
      songguihua8868@163.com.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Yu, Suping
AU  - Yu S
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Sun, Mengmeng
AU  - Sun M
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Zhang, Bingxue
AU  - Zhang B
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Peng, Minghao
AU  - Peng M
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Lv, Weigang
AU  - Lv W
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
FAU - Zhou, Hongyun
AU  - Zhou H
AD  - Department of Pediatric, The First Affiliated Hospital of Henan University of 
      TCM, 19 Renmin Road, Jinshui District, 450000, Zhengzhou, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230526
PL  - United States
TA  - Pediatr Res
JT  - Pediatric research
JID - 0100714
RN  - 0 (Macrolides)
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Humans
MH  - Child
MH  - *Macrolides/adverse effects
MH  - Anti-Bacterial Agents/adverse effects
MH  - *Bronchiectasis/diagnosis/drug therapy/chemically induced
MH  - Respiratory Function Tests
MH  - Forced Expiratory Volume
MH  - Randomized Controlled Trials as Topic
EDAT- 2023/05/27 09:41
MHDA- 2023/11/06 06:42
CRDT- 2023/05/26 23:24
PHST- 2022/09/08 00:00 [received]
PHST- 2023/03/20 00:00 [accepted]
PHST- 2023/03/16 00:00 [revised]
PHST- 2023/11/06 06:42 [medline]
PHST- 2023/05/27 09:41 [pubmed]
PHST- 2023/05/26 23:24 [entrez]
AID - 10.1038/s41390-023-02591-5 [pii]
AID - 10.1038/s41390-023-02591-5 [doi]
PST - ppublish
SO  - Pediatr Res. 2023 Nov;94(5):1600-1608. doi: 10.1038/s41390-023-02591-5. Epub 2023 
      May 26.