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J. Clin. Med. 2018, 7(11), 432; https://doi.org/10.3390/jcm7110432

Effects of Macrolide Treatment during the Hospitalization of Children with Childhood Wheezing Disease: A Systematic Review and Meta-Analysis

1
Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 30071, Taiwan
2
Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu 30071, Taiwan
3
Institue of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 10055, Taiwan
4
Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City 25160, Taiwan
5
Department of Family Medicine, Taipei MacKay Memorial Hospital, Taipei 10449, Taiwan
6
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan
7
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
8
Graduate Institue of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
*
Author to whom correspondence should be addressed.
Received: 14 October 2018 / Revised: 28 October 2018 / Accepted: 7 November 2018 / Published: 9 November 2018
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Abstract

Children are susceptible to a variety of respiratory infections. Wheezing is a common sign presented by children with respiratory infections. Asthma, bronchiolitis, and bronchitis are common causes of childhood wheezing disease (CWD) and are regarded as overlapping disease spectra. Macrolides are common antimicrobial agents with anti-inflammatory effects. We conducted a comprehensive literature search and a systematic review of studies that investigated the influences of macrolide treatment on CWD. The primary outcomes were the impact of macrolides on hospitalization courses of patients with CWD. Data pertaining to the study population, macrolide treatment, hospital courses, and recurrences were analyzed. Twenty-three studies with a combined study population of 2210 patients were included in the systematic review. Any kind of benefit from macrolide treatment was observed in approximately two-thirds of the studies (15/23). Eight studies were included in the meta-analysis to investigate the influence of macrolides on the length of stay (LOS), duration of oxygen demand (DOD), symptoms and signs of respiratory distress, and re-admission rates. Although the benefits of macrolide treatment were reported in several of the studies, no significant differences in LOS, DOD, symptoms and signs of respiratory distress, or re-admission rates were observed in patients undergoing macrolide treatment. In conclusion, any kind of benefit of macrolide treatment was observed in approximately two-thirds of the studies; however, no obvious benefits of macrolide treatment were observed in the hospitalization courses of children with CWD. The routine use of macrolides to improve the hospitalization course of children with CWD is not suggested. View Full-Text
Keywords: wheezing; asthma; bronchiolitis; macrolide; azithromycin; childhood wheezing disease wheezing; asthma; bronchiolitis; macrolide; azithromycin; childhood wheezing disease
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Lin, C.-Y.; Yeh, T.-L.; Liu, S.-J.; Lin, H.-H.; Cheng, Y.-J.; Hung, H.-H.; Tsai, M.-C.; Liu, J.-M.; Lei, W.-T. Effects of Macrolide Treatment during the Hospitalization of Children with Childhood Wheezing Disease: A Systematic Review and Meta-Analysis. J. Clin. Med. 2018, 7, 432.

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