Efficacy and safety of reduning injection combined with azithromycin in the treatment of mycoplasma pneumonia among children: A systematic review and meta-analysis

Abstract

Background: Reduning (RDN) injection is a well-known traditional Chinese medicine (TCM) preparation that can be used as an alternative to antibiotics with synergistic and toxicity-reducing effects. In China, RDN is widely used in the combined treatment of infectious diseases.

Objective: To evaluate the clinical efficacy of RDN combined with azithromycin (AZM) for the treatment of mycoplasma pneumonia (MP) among children and to determine its safety, providing an evidence-based reference for clinical treatment.

Methods: Eight databases were searched, including 4 English databases, namely, PubMed, EMBASE, the Cochrane Library, and Web of Science, and 4 Chinese databases, namely, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (CQVIP), and Sino-Med. Randomized controlled trials (RCTs) were included in which RDN was combined with AZM for the treatment of MP pediatric patients. A comprehensive search was performed from the inception of each database until April 25, 2022.

Results: A total of 20 studies covering 1628 children were included. Meta-analysis showed that the clinical effectiveness rate (RR = 1.20, 95% CI [1.15, 1.26], I² = 0%), time elapsed until disappearance of cough (MD = -2.04, 95% CI [-2.67, -1.41], I² = 91%), time elapsed until disappearance of lung rales (MD = -2.55, 95% CI [-3.12, -1.98], I² = 95%), time elapsed until reduction of fever (MD = -1.93, 95% CI [-2.37, -1.49], I² = 92%), TNF-α level after treatment (SMD = -1.17, 95% CI [-1.96, -0.39], I² = 97%), and IL-6 levels after treatment (SMD = -2.65, 95% CI [-3.51, -1.78], I² = 97%) of the combined treatment of MPP were superior to those of other methods, and incidence of adverse reactions (RR = 0.75, 95% CI [0.56, 1.00], I² = 0%) showed statistically significant differences.

Conclusion: RDN combined with AZM for the treatment of MP among children results in increased clinical efficacy with high safety.

Keywords: Azithromycin; Children; Mycoplasma; Pneumonia; Reduning injection.