Oral Azithromycin For Treatment Of Asthma In Adults:-A Meta-analysis Of Randomized Clinical Trials

Objective:Bronchial asthma?asthma?is a very common chronic disease.The current preferred treatment option is a stepped treatment based on inhaled corticosteroids?ICS?.Nowadays,people's diagnosis and treatment of asthma is quite standard.Most patients can receive effective treatment using existing protocols.However,some patients are still insensitive to combined multidrug therapy.Therefore,the best solution for asthma still needs to be explored.As a representative of macrolide antibiotics,azithromycin has antibacterial activity,inhibits mucus secretion,inhibits release of inflammatory mediators,performs immunoregulation,reduces airway hyperresponsiveness,and exerts a hormone-like effect.It can relieve asthma sympto-ms,but azithromycin The treatment of asthma is still controversial.At present,it does not have sufficient evidence for evidence.Moreover,asthma is a heterogeneous disease,and exploring multiple treatment options can provide different options for asthma treatment.Therefore,azithromycin still has important potential value for asthma.This study intends to search domestic and foreign related literature and use meta-analysis to explore the efficacy of oral azithromycin in the treatment of adult bronchial.Methods:This article searches for electronic computer databases such as PubMed,EMBase,The Cochrane Library,China Knowledge Network,Weipu,Wanfang,etc.We set the search time span from January 2000 to January 2018.Clinical studies of randomized controlled trials?RCTs?on the efficacy and safety of oral azithromycin in the treatment of adult bronchial asthma were included in the article.For quality evaluation of documents that meet the inclusion criteria,we finally used RevMan 5.3.5?Mac version?statistical software for data processing.Results:A total of 11 systematic reviews of oral azithromycin for adult asthma were included in this article.There were 522 patients in the azithromycin group,504patients in the conventional treatment group and the conventional treatment group and placebo group.The meta-analysis showed:1.In the lung function,the azithromycin group did not significantly improve the level of FEV₁ after treatment[WMD=0.11,95%CI?0.07,0.29?,P>0.05],The subgroup analysis of Chinese people also showed no significant advantage in improving FEV₁ levels[WMD=0.15,95%CI?-0.07,0.37?,P>0.05],Azithromycin also had no advantage in improving the FEV₁%difference before and after treatment[WMD=2.03,95%CI?-1.36,5.43?,P>0.05],There was an improvement in the post-treatment level of FEV₁/FVC[WMD=7.80,95%CI?3.82,11.77?,P<0.05],and the combination therapy group had a decreased FeNO level after treatment[WMD=-7.11,95%CI?-22.27?,-1.15),P<0.05],Among the subgroups for Chinese people,there is also an improvement effect on FeNO[WMD=-17.73,95%CI?-27.21,-8.25?],P=0.0002,2.In terms of improving symptoms,it was suggested that the ACT score after treatment was improved[WMD=2.39,95%CI?1.39,3.39?,P<0.05],However,there was no improvement in ACQ scores[WMD=-0.06,95%CI?-0.15,0.04?,P>0.05].There was no advantage in improving the AQLQ score[WMD=0.05,95%CI?-0.17,0.28?,P>0.05].Only one report had serious adverse reactions,but there were no statistically significant differences between the two groups.The rest reported only minor adverse reactions or no adverse reactions.Conclusion:?1?In the case of co-administration of azithromycin,there was an advantage in improving FEV₁/FVC%,FeNO,ACT and AQLQ scores that control asthma symptoms,and there was no obvious advantage in improving FEV₁,FEV₁%,and ACQ scores.?2?A Chinese subgroup analysis using FEV₁ and FeNO indicated that the combination of azithromycin for adult asthma did not show different efficacy due to Chinese ethnicity.?3?Azithromycin was well tolerated in the treatment of asthma,and most patients had no serious adverse reactions or only minor adverse reactions.