Xiyanping Plus Azithromycin Chemotherapy in Pediatric Patients with Mycoplasma pneumoniae Pneumonia: A Systematic Review and Meta-Analysis of Efficacy and Safety.

Qiao Li,Hui Xu,Fa-Xin Sun,Jie Zhang,Wen-Na Guo,Zhi-Yong Li,Xiao-Meng Xu

doi:10.1155/2019/2346583

Qiao Li, Hui Xu + Show 5 more

Open Access

https://doi.org/10.1155/2019/2346583

Copy DOI

Abstract

Background Xiyanping injection (XYP) is a well-known Chinese medicinal preparation reputed as a most effective alternative to antibiotics. XYP has been widely used in combination therapies to treat various infectious diseases, among which XYP plus azithromycin (AZM) chemotherapy is often used for the treatment of Mycoplasma pneumoniae pneumonia in pediatric patients (p-MPP) in China. Objective The present study just aimed to confirm whether XYP can improve the clinical efficacy and safety of AZM chemotherapy for p-MPP by performing meta-analysis and systematic review. Methods A meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The randomized controlled trials (RCTs) concerning XYP plus AZM chemotherapy for p-MPP were selected, for which the main outcomes included overall response rate (ORR), antipyretic time, cough disappearance time, lung wet Rales disappearance time, hospitalization duration, and adverse drug reactions (ADRs). Based on the data extracted, the meta-analysis was conducted by using a standard data extraction form. Results Nine RCTs involving 963 patients were included for meta-analysis. More concretely, the combination therapy showed the risk ratio (RR) and 95% confidence intervals (CI) of ORR and ADRs as (RR, 1.21 [95% CI, 1.15, 1.28]) and (RR, 0.37 [95% CI, 0.27, 0.51]), respectively. And other major outcomes were as follows: hospitalization durations (standard mean difference (SMD), −1.32 [95% CI, −1.48, −1.16]), antipyretic time (SMD, −1.26 [95% CI, −1.70, −0.83]), cough disappearance time (SMD, −1.07 [95% CI, −1.38, −0.75]), and the disappearance time of lung wet Rales (SMD, −0.83 [95% CI, −1.07, −0.60]). With statistically significant differences in various aspects, the combination therapy plus XYP displayed obvious advantages in contrast to AZM alone. Conclusion Overall, XYP might reduce the incidence of ADRs and significantly improve the clinical efficacy for p-MPP receiving AZM chemotherapy.

Highlights

Mycoplasma pneumoniae pneumonia (MPP) is a kind of respiratory disease caused by mycoplasma infection, which has a high incidence and mortality and occurs more frequently in children [1, 2]
All the included nine trials randomized patients to either the treatment of AZM alone or Xiyanping injection (XYP) plus AZM chemotherapy, among which there were 7 studies utilizing the random number table method to divide the participants into the experiment or control group, one using the drawing lots and grouping method to allocate the subjects, and the other one adopting a randomly grouping method by a computer to divide participants into two groups
The findings clearly revealed that the clinical application of XYP plus AZM chemotherapy for pneumonia in pediatric patients (p-MPP) was associated with a significantly higher overall response rate (ORR) than AZM alone. e analysis of outcomes further demonstrated statistical heterogeneity in

Summary

Background

Xiyanping injection (XYP) is a well-known Chinese medicinal preparation reputed as a most effective alternative to antibiotics. E present study just aimed to confirm whether XYP can improve the clinical efficacy and safety of AZM chemotherapy for p-MPP by performing meta-analysis and systematic review. E randomized controlled trials (RCTs) concerning XYP plus AZM chemotherapy for p-MPP were selected, for which the main outcomes included overall response rate (ORR), antipyretic time, cough disappearance time, lung wet Rales disappearance time, hospitalization duration, and adverse drug reactions (ADRs). Other major outcomes were as follows: hospitalization durations (standard mean difference (SMD), − 1.32 [95% CI, − 1.48, − 1.16]), antipyretic time (SMD, − 1.26 [95% CI, − 1.70, − 0.83]), cough disappearance time (SMD, − 1.07 [95% CI, − 1.38, − 0.75]), and the disappearance time of lung wet Rales (SMD, − 0.83 [95% CI, − 1.07, − 0.60]). XYP might reduce the incidence of ADRs and significantly improve the clinical efficacy for p-MPP receiving AZM chemotherapy

Introduction

Results

Discussion

Conclusion