OBJECTIVE: To evaluate and compare the efficacy and safety of bronchodilators and @entity230 , alone or combined, for the acute management of @entity5924 in @entity1 aged less than 2 years. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, Central, Scopus, PubMed, LILACS, IranMedEx, conference proceedings, and trial registers. Inclusion criteria Randomised controlled trials of @entity1 aged 24 months or less with a first episode of @entity5924 with wheezing comparing any bronchodilator or @entity134 , alone or combined, with placebo or another intervention (other bronchodilator, other @entity134 , standard care). REVIEW METHODS: Two reviewers assessed studies for inclusion and risk of bias and extracted data. Primary outcomes were selected by clinicians a priori based on clinical relevance: rate of admission for outpatients (day 1 and up to day 7) and length of stay for inpatients. Direct meta-analyses were carried out using random effects models. A mixed treatment comparison using a Bayesian network model was used to compare all interventions simultaneously. RESULTS: 48 trials (4897 @entity1 , 13 comparisons) were included. Risk of bias was low in 17% (n = 8), unclear in 52% (n = 25), and high in 31% (n = 15). Only @entity1425 ( @entity1425 ) reduced admissions on day 1 (compared with placebo: pooled risk ratio 0.67, 95% confidence interval 0.50 to 0.89; number needed to treat 15, 95% confidence interval 10 to 45 for a baseline risk of 20%; 920 @entity1 ). Unadjusted results from a single large trial with low risk of bias showed that combined @entity619 and @entity1425 reduced admissions on day 7 (risk ratio 0.65, 0.44 to 0.95; number needed to treat 11, 7 to 76 for a baseline risk of 26%; 400 @entity1 ). A mixed treatment comparison supported @entity1425 alone or combined with @entity230 as the preferred treatments for outpatients (probability of being the best treatment based on admissions at day 1 were 45% and 39%, respectively). The incidence of reported harms did not differ. None of the interventions examined showed clear efficacy for length of stay among inpatients. CONCLUSIONS: Evidence shows the effectiveness and superiority of @entity1425 for outcomes of most clinical relevance among outpatients with acute @entity5924 , and evidence from a single precise trial for combined @entity1425 and @entity619 .

@entity230 and bronchodilators for acute XXXX in the first two years of life: systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity1425 :: ('MESH:D004837', 'Chemical') :: ['epinephrine', 'adrenaline'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity5924 :: ('MESH:D001988', 'Disease') :: ['bronchiolitis'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity230 :: ('MESH:D013256', 'Chemical') :: ['steroids']
@entity5924 :: (MESH:D001988,Disease) :: ['bronchiolitis']
