{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:06:19Z","timestamp":1758931579317,"version":"3.44.0"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["ARM"],"abstract":"<jats:p>Respiratory infections and chronic lung disease are major contributors to morbidity in children. Aztreonam lysine for inhalation (AZLI) delivers high local antibiotic concentrations while limiting systemic exposure; however, its safety in younger patients remains uncertain. This systematic review and meta-analysis searched MEDLINE, CENTRAL, and Google Scholar for randomized and observational studies reporting adverse events in children and adolescents (\u226418 years) receiving AZLI, with no date limit. Fourteen studies were included. Most studies were moderate-to-high quality. Comparative analysis showed no clinically relevant increase in common adverse events relative to placebo or other inhaled antibiotics. The pooled relative risk for severe respiratory disorders (grade 3\/4) was 1.65 (95% CI 1.07\u20132.57), suggesting a higher incidence of serious respiratory events, while a protective effect against decline in pulmonary function was observed (RR 0.70, 95% CI 0.54\u20130.90). Adverse events were generally mild; serious adverse events and hospitalizations were infrequent and comparable between groups. Cumulative prevalence estimates indicated that respiratory irritation occurred in 10\u201325% of patients, whereas systemic effects were uncommon. Overall, AZLI appears to have an acceptable tolerability and safety profile in children and adolescents, though careful monitoring is warranted, especially for severe respiratory events.<\/jats:p>","DOI":"10.3390\/arm93050038","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T08:31:28Z","timestamp":1758875488000},"page":"38","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Tolerability of Inhaled Aztreonam in Children and Adolescents: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8350-6995","authenticated-orcid":false,"given":"Valmir N.","family":"Rastely-Junior","sequence":"first","affiliation":[{"name":"Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hosanea S. N.","family":"Rocha","sequence":"additional","affiliation":[{"name":"Departamento de Medicina, Escola Bahiana de Medicina e Sa\u00fade P\u00fablica (EBMSP), Salvador 40290-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-9060","authenticated-orcid":false,"given":"Mitermayer G.","family":"Reis","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador 40026-010, Brazil"},{"name":"Departamento de Medicina, Escola Bahiana de Medicina e Sa\u00fade P\u00fablica (EBMSP), Salvador 40290-000, Brazil"},{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz (Fiocruz), Salvador 40296-710, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization: WHO (2025, July 07). 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