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The efficacy and safety of acetylcysteine combined with budesonide nebulization in treating mycoplasma pneumonia in children: a meta-analysis

Yinan He, Rongmei Huang

Frontiers in Pediatrics, 2025

4,300 participants · 2 citations

Abstract

Background The aim of this meta-analysis was to systematically evaluate the clinical efficacy and safety of acetylcysteine combined with budesonide nebulization in treating Mycoplasma pneumonia in children. Methods We systematically searched eight electronic databases for randomized controlled trials (RCTs) evaluating the use of acetylcysteine combined with budesonide nebulization in treating Mycoplasma pneumonia in children, from database inception through December 2024, and performed data analysis using a random-effects model. Results The 29 RCTs involving 4,300 children were conducted. The experimental group received acetylcysteine plus budesonide treatment, while the comparison group received budesonide alone. Results showed the experimental group had a significantly higher overall clinical efficacy rate (RR = 1.16, 95% CI = 1.13–1.20, I2 = 16%). The experimental group also had a significantly lower incidence of diarrhea (RR = 0.17, 95% CI = 0.05–0.54, I2 = 0%), with no significant difference in other adverse events. The experimental group had significantly shorter times to resolution of cough (SMD = −2.11, 95% CI = −2.65 to −1.57, I2 = 97%), moist rale (SMD = −1.91, 95% CI = −2.50 to −1.33, I2 = 97%), and fever (SMD = −1.70, 95% CI = −2.26 to −1.14, I2 = 95%). Post-treatment, the experimental group had significantly lower C-reactive protein levels (SMD = −1.44, 95% CI = −1.92 to −0.97, I2 = 91%). Conclusion Compared with budesonide monotherapy, acetylcysteine combined…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 4,300 participants or records.

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