Clinical effects of atomizing inhalation of antibiotics on germ clearance rate and adverse reactions in respiratory infectious diseases: A meta-analysis

To assess the effects of atomizing inhalation of antibiotics on germ clearance rate and adverse reactions in respiratory infectious diseases. Atomizing inhalation of antibiotics is an innovative local drug delivery strategy. PubMed, Medline, and Web of Science were searched systematically for appropriate clinical studies on atomizing inhalation of antibiotics for respiratory infectious diseases (patients diagnosed with respiratory infectious diseases; intervention: atomizing inhalation of antibiotics; comparison: oral or intravenous administration). Basic data recorded: sample size, follow-up time, germ clearance rate, adverse reactions and other outcome indicators. A meta-analysis was performed using RevMan 5.3 software. Six independent studies involving 245 patients with respiratory infectious diseases were included. There were 131 patients in the experimental group using atomizing inhalation of antibiotics and 114 patients in the control group utilizing oral or intravenous administration. Atomizing inhalation of antibiotics significantly increased the germ clearance rate (defined by no organism growth in culture and no visible organisms), and reduced number, frequency, and severity of adverse reactions compared with the controls. The advantages of atomizing inhalation of antibiotics may be attributed to the direct working of drugs on the infection site, increasing local drug concentrations, and thus killing germs more effectively. However, there are differences in the types and doses of antibiotics, atomizing units, and underlying diseases of patients across studies. Atomizing inhalation of antibiotics exerts significantly better germ clearance effects while decreasing the incidence of adverse reactions than does oral or intravenous administration in the treatment of respiratory infectious diseases.