TITLE:
Carbocysteine as Adjuvant Therapy in Acute Respiratory Tract Infections in Patients without Underlying Chronic Conditions: Systematic Review and Meta-Analysis
AUTHORS:
Myriam Calle Rubio, Olga de la Serna Blazquez, José Luis R. Martin, Manuel Ruiz Cuetos
KEYWORDS:
Acute Respiratory Infections, Carbocystenine, Systematic Review, Meta-Analysis
JOURNAL NAME:
Open Journal of Respiratory Diseases,
Vol.14 No.2,
March
29,
2024
ABSTRACT: 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.