Comparative effectiveness and safety of xiyanping with ribavirin for rotavirus enteritis therapy in childhood: A systematic review and meta-analysis

Purpose : To employ meta-analysis to assess the effectiveness and adverse events of Xiyanping and ribavirin in children with rotavirus enteritis. Methods : Searches included PubMed, Embase, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine Database (CBM), China Science and Technology Journal Database (VIP database), and Wanfang database from inception to March 2017. Clinical indicators, with respect to the total effectiveness rate, fever time, duration of diarrhea, creatinine kinase MB isoenzyme (CK-MB), rotavirus (RV) negative conversion rate, and adverse reaction, were compared between Xiyanping and ribavirin groups. Results : Five-hundred and twenty-six records were obtained after searching the databases, and 18 studies (3557 participants) that met the inclusion criteria were included. All of them assessed total effectiveness rate, and two records evaluated RV negative conversion rate. There were significantly higher rates in the Xiyanping group than in the ribavirin group {OR = 3.76, 95 %CI (3.03 - 4.66), p < 0.00001; OR = 2.68, 95 %CI (1.56 - 4.60), p = 0.0004}. Compared with ribavirin group, fever time, duration of diarrhea, and creatine kinase isoenzyme MB (CK-MB) were significantly lower in xiyanping group [MD = -1.23, 95 %CI (-1.64 to -0.81), p < 0.00001; MD= -2.15, 95 %CI (-2.68 to -1.62), p < 0.00001; MD = -16.90, 95 %CI (-17.23 to -16.57), p < 0.00001}. Six studies reported adverse reactions, but there was no significant difference between xiyanping and ribavirin groups {OR = 1.44, 95 %CI (0.40 - 5.17), p = 0.58}. Conclusion : This review suggests that xiyanping is more effective than ribavirin in children suffering from rotavirus enteritis. Keywords : Ribavirin, Rotavirus enteritis, Systematic review, Virazole®, Xiyanping