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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Comparison 1 Length of symptoms (not specified), Outcome 1 Duration of symptoms.
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Analysis 1.1

Comparison 1 Length of symptoms (not specified), Outcome 1 Duration of symptoms.

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Comparison 1 Length of symptoms (not specified), Outcome 2 Duration of fever (days).
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Analysis 1.2

Comparison 1 Length of symptoms (not specified), Outcome 2 Duration of fever (days).

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Comparison 2 Death, Outcome 1 Deaths.
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Analysis 2.1

Comparison 2 Death, Outcome 1 Deaths.

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Comparison 3 Length of hospital stay, Outcome 1 Length of hospital stay.
Figuras y tablas -
Analysis 3.1

Comparison 3 Length of hospital stay, Outcome 1 Length of hospital stay.

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Comparison 4 Use of alternative therapy, Outcome 1 Use of alternative therapy.
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Analysis 4.1

Comparison 4 Use of alternative therapy, Outcome 1 Use of alternative therapy.

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Comparison 4 Use of alternative therapy, Outcome 2 Duration of bronchodilator use.
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Analysis 4.2

Comparison 4 Use of alternative therapy, Outcome 2 Duration of bronchodilator use.

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Comparison 4 Use of alternative therapy, Outcome 3 Days of supplementary oxygen.
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Analysis 4.3

Comparison 4 Use of alternative therapy, Outcome 3 Days of supplementary oxygen.

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Comparison 4 Use of alternative therapy, Outcome 4 Days of tube feeding.
Figuras y tablas -
Analysis 4.4

Comparison 4 Use of alternative therapy, Outcome 4 Days of tube feeding.

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Comparison 5 PICU admission, Outcome 1 PICU admission.
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Analysis 5.1

Comparison 5 PICU admission, Outcome 1 PICU admission.

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Comparison 6 Re‐admission, Outcome 1 Re‐admission.
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Analysis 6.1

Comparison 6 Re‐admission, Outcome 1 Re‐admission.

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Comparison 7 Symptoms, Outcome 1 Wheeze.
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Analysis 7.1

Comparison 7 Symptoms, Outcome 1 Wheeze.

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Comparison 7 Symptoms, Outcome 2 Shortness of breath.
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Analysis 7.2

Comparison 7 Symptoms, Outcome 2 Shortness of breath.

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Comparison 7 Symptoms, Outcome 3 Oxygen saturation (< 96%).
Figuras y tablas -
Analysis 7.3

Comparison 7 Symptoms, Outcome 3 Oxygen saturation (< 96%).

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Comparison 7 Symptoms, Outcome 4 Not smiling socially.
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Analysis 7.4

Comparison 7 Symptoms, Outcome 4 Not smiling socially.

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Comparison 7 Symptoms, Outcome 5 Feeding difficulties.
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Analysis 7.5

Comparison 7 Symptoms, Outcome 5 Feeding difficulties.

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Comparison 7 Symptoms, Outcome 6 Fever.
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Analysis 7.6

Comparison 7 Symptoms, Outcome 6 Fever.

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Comparison 7 Symptoms, Outcome 7 Cough.
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Analysis 7.7

Comparison 7 Symptoms, Outcome 7 Cough.

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Table 1. Kneyber: azithromycin versus placebo for bronchiolitis

Variable

Azithromycin (n = 32)

Placebo

(n = 39)

Outcome

Significance level

Days of symptoms

4.94 (SD 3.78)

4.62 (SD 2.05)

Mean difference 0.32 (95% CI ‐1.14 to 1.78)

P = 0.65

Days in hospital

5.5 (SD 2.54)

5.82 (SD 1.98)

Mean difference ‐0.32 (95% CI ‐1.40 to 0.76)

P = 0.56

Duration of fever (days)

1.47 (SD 1.41)

1.00 (SD 1.08)

Mean difference 0.47 (95% CI ‐0.12 to 1.06)

P = 0.12

Duration of bronchodilator use

2.79 (SD 2.49)

2.96 (SD 2.06)

Mean difference ‐0.17 (95% CI ‐1.25 to 0.91)

P = 0.81

Bronchodilator use

17

23

Odds ratio 0.79 (95% CI 0.31 to 2.02)

P = 0.62

Supplementary oxygen

20 (62.5%)

31 (79.49%)

Odds ratio 0.43 (95% CI 0.15 to 1.24)

P = 0.11

Days of extra oxygen

3.75 (SD 1.74)

3.39 (SD 1.78)

Mean difference 0.36 (95% CI ‐0.46 to 1.18)

P = 0.48

PICU admission

0 (0%)

1 (2.56%)

Odds ratio 0.39 (95% CI 0.02 to 10.03)

P = 1.00

Tube feeding

16 (50.00%)

16 (41.03%)

Odds ratio 1.44 (95% CI 0.56 to 3.69)

P = 0.45

Days of tube feeding

1.90 (SD 2.13)

1.83 (SD 2.36)

Mean difference 0.07 (95% CI ‐0.98 to 1.12)

P = 0.90

PICU: paediatric intensive care unit
SD: standard deviation
CI: confidence interval

Figuras y tablas -
Table 1. Kneyber: azithromycin versus placebo for bronchiolitis
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Table 2. Mazumder: IV ampicillin versus oral erythromycin versus control

Variable

Day 1

Outcome

Day 3

Outcome

Day 5

Outcome

IV ampicillin

Oral erythromycin

Control

Chi2 test (P value)

IV ampicillin

Oral erythromycin

Control

Chi2 test (P value)

IV ampicillin

Oral erythromycin

Control

Chi2 test

(P value)

Wheeze

29/29 (100%)

32/32 (100%)

43/43 (100%)

N/A

16/29 (55%)

2/32 (6%)

26/43 (60%)

24.82 (P < 0.001)

6/29 (21%)

7/32 (22%)

2/43 (5%)

5.69 (P = 0.058)

Shortness of breath

29/29 (100%)

32/32 (100%)

43/43 (100%)

N/A

18/29 (62%)

16/32 (50%)

27/43 (63%)

1.97 (P = 0.37)

8/29 (28%)

8/32 (25%)

15/43 (35%)

0.95 (P = 0.62)

Oxygen saturation (< 96%)

18/29 (62%)

15/32 (47%)

23/43 (53%)

1.42 (P = 0.49)

8/29 (28%)

7/32 (22%)

5/43 (12%)

3.05 (P = 0.22)

2/29 (7%)

3/32 (9%)

2/43 (5%)

0.65 (P = 0.72)

Not smiling socially

19/29 (66%)

21/32 (66%)

30/43 (70%)

0.20 (P = 0.90)

3/29 (10%)

3/32 (9%)

5/43 (12%)

0.10 (P = 0.95)

0/29 (0%)

0/32 (0%)

0/43 (0%)

N/A

Feeding difficulty

12/29 (41%)

13/32 (41%)

25/43 (58%)

2.98 (P = 0.23)

3/29 (10%)

3/32 (9%)

5/43 (12%)

0.10 (P = 0.95)

0/29 (0%)

0/32 (0%)

0/43 (0%)

N/A

IV: intravenous
Figuras y tablas -
Table 2. Mazumder: IV ampicillin versus oral erythromycin versus control
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Table 3. Kabir: IV ampicillin versus oral erythromycin versus control

Variable

Intervention

Outcome

IV ampicillin

Oral erythromycin

Control

Chi2 test (P value)

Day 2

Oxygen sats (< 90%)

2/99 (2%)

6/99 (6%)

6/97 (6%)

2.45 (P = 0.29)

Fever

5/99 (5%)

6/99 (6%)

4/97 (4%)

0.38 (P = 0.83)

Day 7

Wheeze

8/99 (8%)

9/99 (9%)

4/97 (4%)

2.04 (P = 0.36)

Shortness of breath

8/99 (8%)

9/99 (9%)

2/97 (2%)

4.68 (P = 0.10)

Cough

10/99 (10%)

9/99 (9%)

3/97 (3%)

4.06 (P = 0.13)

IV: intravenous
PICU: paediatric intensive care unit
SD: standard deviation
CI: confidence interval

Figuras y tablas -
Table 3. Kabir: IV ampicillin versus oral erythromycin versus control
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Comparison 1. Length of symptoms (not specified)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Duration of symptoms Show forest plot

2

123

Mean Difference (IV, Fixed, 95% CI)

0.32 [‐1.14, 1.78]

2 Duration of fever (days) Show forest plot

1

71

Mean Difference (IV, Fixed, 95% CI)

0.47 [‐0.12, 1.06]
Figuras y tablas -
Comparison 1. Length of symptoms (not specified)
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Comparison 2. Death

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Deaths Show forest plot

5

543

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 2. Death
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Comparison 3. Length of hospital stay

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Length of hospital stay Show forest plot

3

288

Mean Difference (IV, Random, 95% CI)

0.34 [‐0.71, 1.38]
Figuras y tablas -
Comparison 3. Length of hospital stay
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Comparison 4. Use of alternative therapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Use of alternative therapy Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Oxygen

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Bronchodilator use

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Corticosteroid use

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.4 Naso‐gastric feeding

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Duration of bronchodilator use Show forest plot

1

71

Mean Difference (IV, Fixed, 95% CI)

‐0.17 [‐1.25, 0.91]

3 Days of supplementary oxygen Show forest plot

1

71

Mean Difference (IV, Fixed, 95% CI)

0.36 [‐0.46, 1.18]

4 Days of tube feeding Show forest plot

1

71

Mean Difference (IV, Fixed, 95% CI)

0.07 [‐0.98, 1.12]
Figuras y tablas -
Comparison 4. Use of alternative therapy
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Comparison 5. PICU admission

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 PICU admission Show forest plot

1

71

Odds Ratio (M‐H, Fixed, 95% CI)

0.39 [0.02, 10.03]
Figuras y tablas -
Comparison 5. PICU admission
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Comparison 6. Re‐admission

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Re‐admission Show forest plot

1

21

Odds Ratio (M‐H, Fixed, 95% CI)

0.11 [0.01, 1.29]
Figuras y tablas -
Comparison 6. Re‐admission
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Comparison 7. Symptoms

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Wheeze Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Day 1

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Day 3

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Day 5

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.4 Day 7

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Shortness of breath Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 Day 1

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 Day 3

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 Day 5

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.4 Day 7

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Oxygen saturation (< 96%) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3.1 Day 1

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 Day 3

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 Day 5

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Not smiling socially Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 Day 1

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 Day 3

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 Day 5

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Feeding difficulties Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5.1 Day 1

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 Day 3

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 Day 5

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Fever Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 Day 2

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Cough Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7.1 Day 7

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 7. Symptoms
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