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. 2023 Oct 19;9(11):e21105.
doi: 10.1016/j.heliyon.2023.e21105. eCollection 2023 Nov.

Meta-analysis of the efficacy of budesonide and ambroxol hydrochloride inhalation in children with pneumonia and their effects on inflammatory response

Huanan Shen  1 , Xingni Zhao  1 , Liangyin Xu  1
Affiliations

Meta-analysis of the efficacy of budesonide and ambroxol hydrochloride inhalation in children with pneumonia and their effects on inflammatory response

Huanan Shen et al. Heliyon. .

Abstract

Childhood pneumonia, often caused by acute upper respiratory tract infections or bronchitis, is one of the leading causes of mortality in children. Nebulized inhalation, as a low-risk treatment method, has garnered significant attention. However, its effectiveness and safety remain controversial. In this study, a systematic review of relevant literature on the use of budesonide (BUD) and ambroxol hydrochloride (AMB) inhalation in the treatment of childhood pneumonia was conducted, and a total of 10 articles were included. The meta-analysis revealed an odds ratio (OR) of 1.61 and an I2 value of 0.00 % for the effectiveness of combined BUD and AMB inhalation therapy in children with pneumonia, indicating no heterogeneity among the studies in terms of effectiveness. The OR values for BUD or AMB inhalation in alleviating cough, lung auscultation abnormalities, respiratory distress, body temperature, and cyanosis of the lips in children with pneumonia all favored the combined BUD therapy, showing significant relief of the aforementioned symptoms. However, due to variations in drug dosage and administration methods, high heterogeneity was observed. This study suggested that combined BUD and AMB inhalation therapy has better efficacy in treating childhood pneumonia, and BUD combined with AMB inhalation is more effective in alleviating symptoms such as cough, lung auscultation abnormalities, respiratory distress, normalizing body temperature, and reducing cyanosis of the lips. Nevertheless, further validation is required due to the limited sample size and substantial heterogeneity in the included studies. To sum up, this study provides the first analysis of the efficacy and inflammatory response of BUD and AMB inhalation in children with pneumonia. Future research should aim to verify and clarify these findings, considering the limitations of the existing studies in terms of sample size and heterogeneity.

Keywords: Ambroxol hydrochloride; Budesonide; aerosol inhalation; meta-analysis; pneumonia.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The process for article retrieval.
Fig. 2
Fig. 2
Evaluation of risk bias of the included articles drawn by RevMan5.3.
Fig. 3
Fig. 3
Summary of risk bias of the included articles drawn by RevMan5.3. Note: “+”, “-”, and “?” represented low risk, high risk, and unclear, respectively.
Fig. 4
Fig. 4
Forest plot of the effectiveness of BUD and the aerosol inhalation of AMB CI: confidence interval; df: degree of freedom.
Fig. 5
Fig. 5
Labbe heterogeneity test on the effectiveness of BUD and the aerosol inhalation of AMB.
Fig. 6
Fig. 6
Funnel plot of the effectiveness of BUD and the aerosol inhalation of AMB.
Fig. 7
Fig. 7
Forest plot of cough disappearance time after the treatment with BUD and the aerosol inhalation of AMB. CI: confidence interval; df: degree of freedom.
Fig. 8
Fig. 8
Galbraith heterogeneity test on postoperative cough disappearance time.
Fig. 9
Fig. 9
Funnel plot of postoperative cough disappearance time.
Fig. 10
Fig. 10
Forest plot of lung rales disappearance time after the treatment with BUD and the aerosol inhalation of AMB. CI: confidence interval; df: degree of freedom.
Fig. 11
Fig. 11
Galbraith heterogeneity test on lung rales disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 12
Fig. 12
Funnel plot of lung rales disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 13
Fig. 13
Forest plot of dyspnea disappearance time after the treatment with BUD and the aerosol inhalation of AMB. CI: confidence interval; df: degree of freedom.
Fig. 14
Fig. 14
Galbraith heterogeneity test on dyspnea disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 15
Fig. 15
Funnel plot of dyspnea disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 16
Fig. 16
Forest plot of fever removal time after the treatment with BUD and the aerosol inhalation of AMB. CI: confidence interval; df: degree of freedom.
Fig. 17
Fig. 17
Galbraith heterogeneity test on fever removal time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 18
Fig. 18
Funnel plot of fever removal time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 19
Fig. 19
Forest plot of lip cyanosis disappearance time after the treatment with BUD and the aerosol inhalation of AMB. CI: confidence interval; df: degree of freedom.
Fig. 20
Fig. 20
Galbraith heterogeneity test on lip cyanosis disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
Fig. 21
Fig. 21
Funnel plot of lip cyanosis disappearance time after the treatment with BUD and the aerosol inhalation of AMB.
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