Clinical efficacy and safety of azithromycin versus amoxicillin-clavulanic acid in the treatment of some acute respiratory infections in children: Systematic evaluation / 国际药学研究杂志

ABSTRACT

Objective To systematically evaluate the clinical efficacy and safety of azithromycin (Az) versus amoxicillin-clavulanic acid (A-Cva) in the treatment of some acute respiratory infections in children. Methods Pubmed, EMBase, Medline, Cochrane Library and CJFD were retrieved to collect the randomized controlled trial (RCT) of their clinical efficacy and safety in the treatment of acute respiratory infections in children. The methodological quality of included studies was evaluated. The RevMan5.2 software was chosen for data analysis. Results Twenty RCTs involving 4980 pediatric patients were included for assessment of the clinical efficacy. Meta-analysis showed that Az had more significant effect on the treatment of some bacterial repiratory infections in children (OR=0.78, 95%CI (0.65,0.93), P=0.007) than A-Cva. In the treatment of upper respiratory infections, acute otitis media and so on, Az had more significant effect (OR=0.75, 95%CI (0.62,0.91), P=0.003); in the treatment of lower respiratory infections, such as community acquired pneumonia and so on, Az and A-Cva acid had the similar effect (OR=1.20, 95%CI(0.62, 2.33), P=0.58). Thirteen RCT involving 3474 pediatric patients were included for assessment of the clinical safety. Meta-analysis shows that the difference between Az and A-Cva is statistic significant in the treatment of some bacterial repiratory infections in children (OR=0.49, 95%CI (0.40, 0.60), P<0.000 01). Conclusion Overall, Meta-analysis shows that Az is more effective and safer in the treatment of some bacterial repiratory infections in children than A-Cva.