The Short And Long Efficacy And Adverse Reactions Of Macrolide Drugs In RSV Infection:A Meta-analysis

Objective:To systemic evaluate the short and long efficacy,and a dverse reactions of macrolide drugs on treating children with Respirat-ory Syncytial Virus infection.Methods:We searched the following database from establishment to 30 in November 2017,such as PubMed Medline,Cochrane Library,Embase,CBM,CNKI,Wanfang and VIP database.The randomized contro-lled trails(RCTs)of macrolide drugs for treating RSV infection in ch-ildren were obtained.The including literature were screened,extracted and mutual verificated by two researchers independently.The quality of the literatures was evaluated by the manual method of Cochrane evaluator system.The hospitalization time,the incidence of adverse reac-tions,the incidence of breathing,and the incidence of asthma were selected as outcome indicators.The effect quantity was expressed by SMD,OR,RR and 95%CI.Meta-analysis was performed by revman5.3software and subgroup analysis was performed according to different kinds of macrolide antibiotics.Results:Finally,4 RCT articles meeting the criteria were include-d,with a total of 394 children,193 from the treatment group and 201 from the control group.The results showed that:(1)For short-term efficacy,there was no significant difference in hospitalization time bet-ween the trial group and the control group[SMD=9.92,95%CI(-0.04,19.89),P=0.05],and the heterogeneity was high(I~2=53%,P=0.12).Diffe-rent kinds of macrolide drugs can cause heterogeneity,After subgroup analysis of different macrolide drugs treatment,the heterogeneity coul-d be eliminated,the hospitalization time could be reduced by using macrolide drugs[azithromycin:SMD=7.30,95%CI(3.02,11.58),P=0.0008;Erythromycin:SMD=18.48,95%CI(6.85,30.11),P=0.002].(2)There was no significant difference in the incidence of adverse reactions bet ween the experimental group and the control group(OR=1.08,95%CI(0.33,3.48),P=0.90).(3)For long-term efficacy,after treatment there wa s significant difference in breathing occurs between two groups[RR=0.64,95%CI(0.44,0.91),P=0.01],experimental group was superior to g eneral treatment for children.(4)After treatment there was no significan t difference in asthma occurs between two groups[OR=0.49,95%CI(0.19,1.27),P=0.14].Conclusion:Whether from short-term efficacy or long-term efficac-y,macrolide drugs have a certain effect on RSV infection,which ca-n shorten the length of hospital stay,reduce the recurrent wheezing after RSV,does not increase the incidence of adverse reactions.Howe-ver,whether the occurrence of asthma after RSV can be reduced,ther-e is no conclusion can be drawn.There are few literatures,so the co-nclusion should be treated with caution.