Comparison of the efficacy of ambroxol hydrochloride and -acetylcysteine in the treatment of children with bronchopneumonia and their influence on prognosis

Clinical efficacy of budesonide combined with acetylcysteine in the treatment of mycoplasma pneumonia infection

OBJECTIVE

Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory tract infectious disease in children. The study aimed to elucidate the therapeutic efficacy of aerosolized budesonide and N-acetylcysteine combination therapy for MP infection in children.

METHODS

One hundred and twenty children with MP infection were included and divided into the control group (received aerosol inhalation of budesonide) and the experimental group (aerosolized budesonide and N-acetylcysteine). After treatment, the disappearance time of clinical symptoms and efficacy were contrasted between the two groups.

RESULTS

With the passage of treatment time, the children's cough score of the two groups were gradually reduced. The children in the experimental group got well from the cough faster than the control group, and the difference reached a significant level on the 5th and 7th days. The time required for fever, rale, and cough to disappear in the experimental group was shorter than those in the control group. As the treatment progressed, a gradual decrease in serum interleukin-6, tumor necrosis factor-α, and C-reactive protein values was detected in both groups, and the decrease was more significant in the experimental group. The total effective rate of the experimental group was 98.33%, which surpassed the control group (93.33%).

CONCLUSION

Budesonide and N-acetylcysteine combination therapy in the treatment of MP infection in children has a significant effect, and can quickly relieve the clinical symptoms of children with good safety. It is worthy of widespread clinical use.

Comparison of Clinical Effectiveness Between Ambroxol and N-Acetylcysteine in Surgical Patients: A Retrospective Cohort Study

Postoperative pulmonary complications (PPCs) are a major cause of postoperative morbidity, mortality, and longer hospital stays. Expectorants are widely used during the perioperative period to reduce PPCs. This study aimed to compare the clinical effectiveness between ambroxol (AMB) and N-acetylcysteine (NAC) in patients undergoing surgery. A multicenter, retrospective cohort study was conducted using deidentified medical records from hospital information system. Between July 1, 2015, and November 30, 2017, patients aged ≥18 years, who received intravenous AMB or nebulized NAC as the only expectorant therapy for >3 days during their hospitalization for thoracic, abdominal, and neurosurgery, were included in this study. The clinical outcomes were evaluated, and propensity score matching was used to adjust significant differences between 2 groups. A total of 4025 cases in the AMB group and 2062 in NAC group after propensity score matching were identified. The incidence of PPCs (13.9% vs 11.6%; P = .013), postoperative sputum suction (17.2% vs 8.0%; P < .001), intensive care unit admission after surgery (25.1% vs 22.5%; P = .024), and postoperative mechanical ventilation (22.3% versus 17.5%; P < .001) in the AMB group were all significantly higher than those in the NAC group. This study suggested that patients treated with NAC during the perioperative period had a significantly lower risk of PPCs. However, further prospective study is needed to ensure the replicability of our findings.

Emphasizing Pulmonary Function With Respiratory Therapy in an Infant With Congenital Adrenal Hyperplasia, Bronchopneumonia and Leptomeningitis

A set of hereditary diseases affecting the adrenal glands, a couple of walnut-sized structures above the kidneys, is known as congenital adrenal hyperplasia (CAH). The adrenal glands generate essential hormones like cortisol, mineralocorticoids, and androgens. It is usually diagnosed in the early neonatal period. The documentation of this case study is aimed to provide a case of an infant with CAH associated with bronchopneumonia and leptomeningitis. Brought with complaints of poor feeding, moderate fever associated with chills, and loose stools, was an 11-months-old patient with a known diagnosis of CAH. Symptoms have shown that the baby was in a possible adrenal crisis. He was intubated with an endotracheal tube after repeated episodes of seizures. Investigations revealed signs of bronchopneumonia and leptomeningitis. A thorough assessment, once completed, helped in analyzing relevant problems to be treated with respiratory therapy. Respiratory therapy, in this case, was aimed at improving the blood oxygen levels and assisting breathing by clearing out secretions and opening up the airways. Parent education was the foremost part of the treatment regime, followed by bronchodilator administration, conventional chest physiotherapy, postural drainage positions in the mother’s lap, lung squeezing technique, and perioral pressure. A holistic and multidisciplinary approach is beneficial in patients with CAH undergoing an adrenal crisis. It needs to be offered to the patients who would be benefited, considering the effect, which needs to be reassessed on specific outcomes with changes in the management with the improving condition.

Efficacy of Ambroxol Hydrochloride Combined with Amoxicillin Potassium Clavulanate Combination on Children with Bronchopneumonia and Its Impact on the Level of Inflammatory Factors

Objective. The goal of the present study was to examine the effect of ambroxol hydrochloride combined with amoxicillin potassium clavulanate combination on children with bronchopneumonia and its influence on the level of inflammatory factors. Methods. From January 2018 to June 2019, 100 children with bronchopneumonia admitted to the Pediatric Department of Nanjing Pukou District Hospital of Traditional Chinese Medicine were enrolled as the study subjects. The children were assigned either to an observation group or a control group in a ratio of 1:1 using the random alphabet method. The observation group was treated with ambroxol hydrochloride plus amoxicillin potassium clavulanate combination, and the control group was treated with amoxicillin potassium clavulanate combination. The therapeutic efficiency and serum white blood cells (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-α) were compared between the two groups. Results. Regarding the effective rate of treatment, the observation group (94%) was observed to be notably higher as compared to the control group (84%). The levels of WBC, CRP, IL-6, and TNF-α were reported to be significantly lower in the two groups after treatment. The WBC, CRP, IL-6, and TNF-α after treatment in the observation group were lower than those in the control group. The time for clinical symptoms to disappear of fever, cough, asthma, and pulmonary rales was all shorter in the observation group. Conclusion. The findings of the present study demonstrate that ambroxol hydrochloride combined with amoxicillin potassium clavulanate combination might be a reliable approach for the treatment of bronchopneumonia in children. It can synergistically relieve inflammation with high safety profiles.

The application of ambroxol hydrochloride combined with fiberoptic bronchoscopy in elderly patients with severe pneumonia: A meta-analysis and systematic review

BACKGROUND

The role of ambroxol hydrochloride combined with fiberoptic bronchoscopy in elderly patients with severe pneumonia remains unclear, we aimed to analyze this issue to provide evidences into the management of clinical pneumonia.

METHODS

We searched PubMed et al databases up to October 20, 2021 for the randomized controlled trials on the application of ambroxol hydrochloride combined with fiberoptic bronchoscopy in elderly patients with severe pneumonia. Related outcomes were extracted and analyzed. Review Manager 5.3 software was used for data analysis.

RESULTS

A total of 13 randomized controlled trials involving 1317 elderly patients (559 cases in the ambroxol hydrochloride + fiberoptic bronchoscopy group and 658 cases in the fiberoptic bronchoscopy group) with pneumonia were included. Meta-analyses indicated that the blood oxygen partial pressure [mean difference (MD) = 5.75, 95% confidence interval (CI) (3.80, 7.70)], blood oxygen saturation [MD = 6.43, 95% CI (4.39, 8.48)], oxygenation index [MD = 26.75, 95% CI (14.61, 38.89)] of experimental group was significantly higher than that of control group (all P < .001), the incidence of multiple organ failure [odds ratio = 0.42, 95% CI (0.31, 0.56), P < .001], mortality on day 28 [odds ratio = 0.44, 95% CI (0.33, 0.59)] of experimental group was significantly less than that of control group (all P < .001).

CONCLUSIONS

The high-dose ambroxol hydrochloride combined with fiberoptic bronchoscopy is beneficial to improve the patient's blood gas indicators, and reduce mortality in elderly patients with severe pneumonia.

Chest Computed Tomography Images in Neonatal Bronchial Pneumonia under the Adaptive Statistical Iterative Reconstruction Algorithm

This study was to explore the application value of chest computed tomography (CT) images processed by artificial intelligence (AI) algorithms in the diagnosis of neonatal bronchial pneumonia (NBP). The AI adaptive statistical iterative reconstruction (ASiR) algorithm was adopted to reconstruct the chest CT image to compare and analyze the effect of the reconstruction of CT image under the ASiR algorithm under different preweight and postweight values based on the objective measurement and subjective evaluation. 85 neonates with pneumonia treated in hospital from September 1, 2015, to July 1, 2020, were selected as the research objects to analyze their CT imaging characteristics. Subsequently, the peripheral blood of healthy neonates during the same period was collected, and the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were detected. The efficiency of CT examination, CRP, ESR, and combined examination in the diagnosis of NBP was analyzed. The results showed that the subjective quality score, lung window subjective score, and mediastinal window subjective score were the highest after CT image reconstruction when the preweight value of the ASiR algorithm was 50%. After treatment, 79 NBP cases (92.9%) showed ground-glass features in CT images. Compared with the healthy neonates, the levels of CRP and ESR in the peripheral blood of neonates with bronchial pneumonia were much lower (P < 0.05). The accuracy rates of CT examination, CRP examination, ESR examination, CRP + ESR examination, and CRP + ESR + CT examination for the diagnosis of NBP were 80.7%, 75.3%, 75.1%, 80.3%, and 98.6%, respectively. CT technology based on AI algorithm showed high clinical application value in the feature analysis of NBP.

Aerosol inhalation of ambroxol hydrochloride combined with terbutaline can promote recovery of children with severe pneumonia

OBJECTIVE

This research aimed to investigate the clinical efficacy of aerosol inhalation of ambroxol hydrochloride combined with terbutaline on children with severe pneumonia, and to evaluate its influence on their immune function and inflammatory level.

METHODS

Totally 113 severe pneumonia children were included. Thereinto, 55 children in the control group (CG) were treated with terbutaline aerosol inhalation, while 58 in the research group (RG) were given ambroxol hydrochloride on the basis of the CG. Their symptom alleviating time, blood gas parameters, adverse reactions during treatment, clinical efficacy, immune function and inflammatory factors were compared.

RESULTS

The time of fever clearance time, disappearance of cough and pulmonary rates, chest shadow absorption and hospitalization of children in the RG were shorter than those in the CG. The combined treatment did not increase additional adverse reactions; instead, its effective rate was markedly higher than that in the CG. Further research found that after treatment, the arterial partial pressure of oxygen (PaO2), oxygenation index (OI), CD4+ and CD4+/CD8+, and interleukin-10 (IL-10) levels were dramatically increased, while the arterial partial pressure of carbon dioxide (PaCO2), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-17 (IL-17) and CD8+ levels were obviously increased. In addition, these indexes of children in the RG were obviously better than those in the CG.

CONCLUSION

Aerosol inhalation of ambroxol hydrochloride combined with terbutaline has a remarkable clinical efficacy on children with severe pneumonia, which can improve their immune function and reduce inflammatory reaction.