Background Sialorrhea in children can be associated with adverse physical and social effects. Treatment using anticholinergic medications has been shown to offer symptomatic relief, but there is no consensus regarding which treatment is the most efficacious. Objective To examine the effectiveness of anticholinergic medications for sialorrhea in children. Methods A systematic review was carried out in Medline, EMBASE, Cochrane, Scopus, and the Web of Science from inception until April 29, 2020. Studies reporting original data on the efficacy of anticholinergic medications in the management of sialorrhea in children aged 0 to 17 years of age were included. This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. Data on study design, setting, population, pharmacologic intervention(s), comparator(s), outcomes, and results were extracted and summarized. Results The search strategy identified 2,800 studies of which 27 articles were included in the synthesis, including five randomized controlled trials. Each anticholinergic undergoing experimental study (glycopyrrolate, scopolamine/hyoscine, trihexyphenidyl/benzhexol, benztropine, and atropine) showed evidence of efficacy. Adverse side effects were common. Significant heterogeneity exists in the studies’ methodology and the variability of outcome measures used between studies precluded a meta-analysis. Conclusions Glycopyrrolate, scopolamine/hyoscine, trihexyphenidyl/benzhexol, benztropine, and atropine have all shown efficacy in the treatment of sialorrhea in children. The small number of reports and the variability in study design precluded a meta-analysis. More studies are needed with uniformity in outcome measures to help guide evidence-based decision making. A guidance table is presented.

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儿童流涎的抗胆碱能治疗：系统评价

背景 儿童流涎可能会带来不良的身体和社会影响。使用抗胆碱能药物治疗已被证明可以缓解症状，但对于哪种治疗最有效尚未达成共识。目的探讨抗胆碱能药物治疗儿童流涎的有效性。方法 从开始到 2020 年 4 月 29 日，在 Medline、EMBASE、Cochrane、Scopus 和 Web of Science 上进行了系统评价。研究报告了抗胆碱能药物治疗 0 至 17 岁儿童流涎的疗效的原始数据年龄也包括在内。本次审查遵循 PRISMA（系统审查和荟萃分析的首选报告项目）标准。提取并总结了有关研究设计、背景、人群、药物干预、比较器、结局和结果的数据。结果 检索策略确定了 2,800 项研究，其中 27 篇文章纳入综合报告，其中包括 5 项随机对照试验。正在进行实验研究的每种抗胆碱能药物（格隆溴铵、东莨菪碱/东莨菪碱、苯海索/苯海索、苯托品和阿托品）都显示出疗效的证据。不良副作用很常见。研究方法存在显着的异质性，并且研究之间使用的结果测量的可变性排除了荟萃分析。结论 格隆溴铵、东莨菪碱/东莨菪碱、苯海索/苯海索、苯托品、阿托品治疗小儿流涎均有效。报告数量较少且研究设计存在差异，无法进行荟萃分析。需要更多的研究来统一结果衡量标准，以帮助指导基于证据的决策。提供了一个指导表。