Ambroxol 30mg/5ml oral solution

ObjectiveTo evaluate the efficacy and safety of ambroxol hydrochloride and clenbuterol hydrochloride oral solution (AHCHOS) in pediatric patients with wheezing disorders and provide a comprehensive evidence map of the current clinical status.MethodsA literature search was conducted in PubMed, Embase, Cochrane Library, CNKI, Wanfang, and CBM to identify randomized controlled trials (RCTs) evaluating the efficacy and safety of AHCHOS in children with wheezing disorders. The clinical status was descriptively summarized. Meta-analyses for efficacy and safety outcomes were performed using a random-effects model in Review Manager 5.4. Outcomes were treatment effectiveness, times to symptom and clinical sign resolution, length of hospital stay, and adverse events (AEs). All time-related outcomes were reported in days.ResultsA total of 227 RCTs were included in the evidence mapping, 14 of which met the criteria for meta-analysis. Evidence mapping revealed a general increase in the number of studies from 2005 to a peak in 2012, followed by a decline. Most studies were conducted in eastern China, particularly in Henan Province. Meta-analysis results demonstrated that combination therapy with AHCHOS significantly improved the overall response rate [risk ratio (RR) 1.26, 95% confidence interval (CI) 1.10-1.44] and significant effective rate (RR 1.55, 95% CI 1.36-1.76). It also significantly reduced the duration (days) of coughing [mean difference (MD) -1.40, 95% CI -1.75 to -1.06], wheezing (MD -1.88, 95% CI -2.50 to -1.26), cough phlegm (MD -2.00, 95% CI -2.76 to -1.24), wet lung sounds (MD -1.82, 95% CI -2.33 to -1.30), pulmonary rales (MD -2.27, 95% CI -2.90 to -1.64), and hospital stay (MD -1.13, 95% CI -1.45 to -0.82). Furthermore, AHCHOS did not increase the risk of AEs compared with conventional treatment alone.ConclusionCombination therapy with AHCHOS was associated with modest but statistically significant improvements in symptom resolution and length of hospital stay compared with conventional treatment alone. However, all included studies were conducted in China, which may limit the generalizability of the findings. In addition, no definitive conclusions regarding safety could be drawn due to limited and inconsistent adverse event reporting. Further safety assessments in future trials are warranted.Systematic review registrationThe protocol has been registered on INPLASY (INPLASY202480121).

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BackgroundRepositioning offers a cost-effective approach to discovering new therapeutic applications for existing medications. Ambroxol, primarily used as a mucolytic for respiratory diseases, has demonstrated anti-inflammatory, analgesic, and antioxidant properties, suggesting potential benefits in non-pulmonary conditions. This study conducted a systematic review to evaluate the efficacy of ambroxol in experimental disease models unrelated to the respiratory system.MethodsFollowing registration in the Open Science Framework and adherence to the PICO strategy for formulating the guiding question, searches were performed in PUBMED/MEDLINE, EMBASE, and SCOPUS using the keywords: (Ambroxol) AND (Anti-Inflammatory Agents OR Analgesics OR Antioxidants) AND (Animals OR in vivo). The SYRCLE tool assessed methodological quality. Among 353 identified records, eight articles met eligibility criteria.ResultsThese studies investigated ambroxol's effects in models of gastric lesions, neuropathic pain, psoriasis-like skin inflammation, hemorrhagic cystitis, and ischemia/reperfusion injuries in the liver and kidneys. Ambroxol doses ranged from 5 to 1000 mg/kg, predominantly administered orally. Its antioxidant properties were demonstrated by reducing free radicals and increasing enzymatic activity (SOD, CAT, GSH). Anti-inflammatory effects included a decrease in pro-inflammatory cytokines (TNF-α, IL-1β) and histological improvements. Antinociceptive action was observed through inhibition of voltage-gated sodium channels and reduction of oxidative stress, alleviating neuropathic pain.ConclusionsDespite ambroxol's widespread clinical use, limited research has explored its non-respiratory applications. Existing studies suggest its promising therapeutic potential, reinforcing the need for further investigation into its role as an alternative treatment for various inflammatory and oxidative stress-related conditions beyond pulmonary diseases.

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ObjectiveTo systematically evaluate the efficacy and safety of commonly used nebulized drugs as adjuvant treatment for non-severe mycoplasma pneumoniae pneumonia (MPP) in children, providing an evidence-based reference for clinical medication.MethodsA computerized search of major Chinese and English literature databases was conducted to collect randomized controlled trials (RCTs) that utilized nebulized drugs in conjunction with azithromycin (AZM) or AZM alone in children with MPP. Following literature screening, the quality of the included studies was evaluated using the risk of bias assessment tool as recommended by the Cochrane Handbook. Outcome data for each measurement were extracted, and a network meta-analysis was conducted using Stata 17.0.ResultsA total of 79 RCTs involving 7,712 patients and 9 interventions were included. The network meta-analysis indicated that all nebulized drugs combined with AZM markedly improved clinical efficacy compared to AZM alone. Among these, the combination of nebulized budesonide plus terbutaline demonstrated superior efficacy and safety as adjunctive therapy for non-severe MPP. Furthermore, Ambroxol combined with AZM was particularly effective in shortening the duration of clinical symptoms such as fever and lung rales. The combinations of terbutaline or budesonide with AZM significantly improved pulmonary function.ConclusionNebulized drug adjuvants to AZM therapy enhance treatment efficacy in children with non-severe MPP without increasing the incidence of adverse events. However, there is a need for more extensive, higher-quality clinical studies to overcome the limitations due to the low quality of some included articles.

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