RİGMAN DARİUS GABRİEL, MUHAMMAD ASADULLAH USMAN, MUHAMMAD AİTZAZ AKRAM, ALLAH RAKHA YASEEN, HAMAİS MURTAZA, ISHTİAQ AHMED
Journal of Clinical Trials and Experimental Investigations - 2024;3(2):46-52
Objective: This meta-analysis aims to systematically review and synthesize the available data on long-term macrolide treatment for NCFB in children.Materials and methods: On December 2, 2023, we conducted a comprehensive search across multiple databases, including PubMed, Cochrane Library, Embase, Web of Sciences, and SCOPUS. There were no restrictions on language. The search terms used were "Macrolides," "Azithromycin," "Clarithromycin," "Roxithromycin," "Erythromycin," "Bronchiectasis," "Kartagener syndrome," and "Ciliary motility disorders." A total of 4 RCTs were included.Results: A total of 92 patients in Macrolid group and 87 patients in control group were included in this meta analysis. Despite variations in macrolide preparations, long-term macrolide use significantly reduced the frequency of acute exacerbations in bronchiectasis (I2=0%) (OR: 0.30, 95% CI: 0.10 to 0.87; p=0.03). The findings showed that long-term macrolide treatment significantly reduced the mean exacerbations per patient (I2=84%; WMD -1.40, 95% CI: -2.26 to -0.54; p=0.001). The results indicated no significant difference in the frequency of exacerbation-related admissions between the azithromycin group and the control group (OR: 0.28, 95% CI: 0.07 to 1.11; p=0.07). The results showed no significant difference in FEV1 between the macrolide treatment group and the control group (I2=80%; WMD 2.21, 95% CI: -2.44 to 6.87; p=0.35). The results indicated no significant difference in the changes of FEV1% predicted before and after treatment between the macrolide group and the control group (I2=0%; WMD 2.19, 95% CI: -2.80 to 7.19; p=0.39).Conclusions: This meta-analysis reveals that long-term macrolide treatment, spanning 3 to 24 months, significantly reduces the frequency of exacerbations in pediatric NCFB.
