Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Oct;44(5):675-684.
doi: 10.1111/jcpt.12855. Epub 2019 May 22.

Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta-analysis of randomized controlled trials

Xiaojiao Duan  1 , Kaihuan Wang  1 , Jiarui Wu  1 , Dan Zhang  1 , Xinkui Liu  1 , Mengwei Ni  1 , Shuyu Liu  1 , Ziqi Meng  1
Affiliations
Review

Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta-analysis of randomized controlled trials

Xiaojiao Duan et al. J Clin Pharm Ther. 2019 Oct.

Abstract

What is known and objective: An increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta-analysis.

Methods: Randomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data.

Results: A total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA.

What is new and conclusion: Yanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.

Keywords: Mycoplasma pneumonia; Chinese herbal injection; azithromycin; mycoplasma pneumonia in children; network meta-analysis; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Design idea and concise workflow
Figure 2
Figure 2
Flow diagram of study search. CBM, Chinese Biomedical Literature Database; CNKI, China National Knowledge Infrastructure Database; n, number of articles; VIP, the Chinese Scientific Journals Full‐text Database; WanFang, Wan‐Fang Database
Figure 3
Figure 3
Network plot for different outcomes. A, clinical effective rate; B, disappearance time of fever; C, disappearance time of cough; D, disappearance time of pulmonary rale; E, average hospitalization time; F, disappearance time of pulmonary shadows in X‐ray; G, TNF‐α; H, IL‐6; RDN, Reduning injection. n, the number of RCTs; TRQ, Tanreqing injection; XXN, Xixinnao injection; XYP, Xiyanping injection; YHN, Yanhuning injection
Figure 4
Figure 4
Assessment of risk bias
Figure 5
Figure 5
Cluster analysis plot for four outcomes. Interventions with the same colour belonged to the same cluster, and interventions located in the upper right corner indicate optimal therapy for two different outcomes
Figure 6
Figure 6
Comparison‐adjusted funnel plot for the rate of clinical efficacy.Points with different colours represent different interventions. If the points distributed in the funnel are symmetrical, there is no publication bias
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Segovia JA, Chang TH, Winter VT, et al. NLRP3 is a Critical Regulator of Inflammation and Innate Immune Cell Response during Mycoplasma pneumoniae Infection. Infect Immun. 2018;86(1):e00548‐e617. - PMC - PubMed
    1. Waites KB, Xiao L, Liu Y, Balish MF, Atkinson TP. Mycoplasma pneumoniae from the Respiratory Tract and Beyond. Clin Microbiol Rev. 2017;30(3):747‐809. - PMC - PubMed
    1. de Groot R, Meyer Sauteur PM, Unger W, van Rossum A. Things that could be Mycoplasma pneumoniae. J Infect. 2017;74:S95‐S100. - PubMed
    1. Copete AR, Aguilar YA, Rueda ZV, Vélez LA. Genotyping and macrolide resistance of Mycoplasma pneumoniae identified in children with community‐acquired pneumonia (CAP) in Medellin‐Colombia. Int J Infect Dis. 2018;66:113‐120. - PMC - PubMed
    1. Jain S, Williams DJ, Arnold SR, et al. Finelli L; CDC EPIC Study Team. Community‐acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015;372(9):835‐845. - PMC - PubMed