Author(s)

Myriam Calle Rubio^1,2,3, Olga de la Serna Blazquez⁴, José Luis R. Martin⁵, Manuel Ruiz Cuetos^6*

¹Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain.
²Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
³Instituto de Investigacion Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
⁴Pediatric Pulmonology Unit, Pediatrics Department, Hospital Universitario La Paz, Madrid, Spain.
⁵Simplifying Research Institute, Layos, Spain.
⁶Medical department in ITF Research Pharma S.L.U., Alcobendas, Spain.

Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: Systematic review and meta-analysis. Data sources: An electronic search was conducted across PubMed, Cochrane Library, clinicaltrials.gov, and the European Clinical Trial Register, with the search dated to May 2023. Bibliographic references from other literature reviews and meta-analyses were also reviewed. The search was limited to randomized clinical trials published in any language and year. It was completed by cross-checking the references of the located articles. Methods: Inclusion criteria covered studies assessing systemic or inhaled carbocysteine, regardless of dosing regimen. Concomitant medication use was acceptable if balanced between intervention and control groups. Authors independently extracted data, resolving disagreements through consensus. Methodological quality assessment relied on critical reading of each study. Dichotomous variables were analyzed using odds ratio (OR), and a final effect size was calculated. Statistical significance was established when confidence intervals did not cross the neutral value. Heterogeneity was assessed via the X² test and I² index. Results: Out of 318 initially identified studies, 4 met inclusion criteria. The meta-analysis for poor general condition yielded an OR of 0.45 in favor of intervention, p = 0.013, with non-significant heterogeneity. Cough events showed a percentage of 15.8% for carbocysteine vs. 27.2% for placebo. On the seventh day, expectoration rates were 18.37% for carbocysteinevs 33.3% for placebo. Conclusions: The observed clinical benefits align with carbocysteine’s mucoactive and muco-regulatory properties, complemented by anti-inflammatory and antioxidant actions. Carbocysteine stands out among mucolytic agents. In the context of persistent infectious diseases, the study emphasizes the need for further exploration of carbocysteine’s therapeutic potential as an adjunctive treatment for acute respiratory infections. These findings underscore its significance in the evolving landscape of respiratory healthcare.

Acute Respiratory Infections, Carbocystenine, Systematic Review, Meta-Analysis

Rubio, M. , Blazquez, O. , Martin, J. and Cuetos, M. (2024) Carbocysteine as Adjuvant Therapy in Acute Respiratory Tract Infections in Patients without Underlying Chronic Conditions: Systematic Review and Meta-Analysis. Open Journal of Respiratory Diseases, 14, 39-50. doi: 10.4236/ojrd.2024.142004.