Azithromycin For Preventing Bronchopulmonary Dysplasia In Preterm Infants:A META Analysis

Background:Some clinical treatment of bronchopulmonary dysplasia (BPD) is still in controversy, researching a safe and effective treatment must be critical.Objective:To assess the effectiveness and safety of azithromycin for preventing BPD in preterm infants.Methods:Electronic database from strategy was established to January 2014, searched from Pubmed,Embase, Ovid,Springer, China Journal Fulltext Database, China Biological Medicine Database,VIP Digital Journal Full-text Database,Wan Fang Digital Database.RCTs were included and assessed for the methodological quality according to Cochrane Handbook for systematic reviews of interventions. Meta-analysis was performed to the extracted data by statistical software Rev Man 5.1.Results:3 RCTs were included. Meta-analyses showed that ① AZM can reduce the incidence of BPD(OR0.67,95%CI:0.50～0.91,P=0.009),② AZM can reduce oxygen time (OR6.13,95% CI:-7.47--4.78,P<0.00001), ③ there was no significant difference in mortality between the two groups,(OR0.92,95%CI:0.78～1.07,P=0.27), ④ there was no significant difference in post-natal steroid use(OR0.85,95%CI:0.65～1.11,P=0.23),⑤ there was no significant difference in hospital days(OR2.48,95%CI:-3. 98～8.95,P=0.45),⑥there was no significant difference in ventilation time (OR-0.68,95%CI:-3.01～1.73,P=0.58). When analyzing the Ureaplasma group,the incidence of BPD was less in the AZM subgroup(P=0.026).No adverse reactions were observed because of AZM.Conclusion:Prophylactic use AZM can reduce the incidence of BPD,especially preterm neonates who are colonized with Ureaplasma spp. Also can reduce the oxygen time after birth. However,considering the sample size, quality, heterogeneity,all kinds of bias exist in the trials, more RCTs with large-scale and high-quality are required.