Background:We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive Mycoplasma pneumoniae (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents.
Methods:We retrospectively analyzed the data of patients with MP pneumonia hospitalized between January 2015 and April 2017. Macrolide-unresponsiveness was clinically defined with a persistent fever of ≥ 38.0°C at ≥ 72 hours after macrolide treatment. The cases were divided into four groups: PMC, CST, DXC, and LFX. We compared the time to defervescence (TTD) after secondary treatment and the TTD after initial macrolide treatment in each group with adjustment using propensity score-matching analysis.
Results:Among 1,165 cases of MP pneumonia, 190 (16.3%) were unresponsive to macrolides. The proportion of patients who achieved defervescence within 48 hours in CST, DXC, and LFX groups were 96.9% (31/33), 85.7% (12/14), and 83.3% (5/6), respectively. The TTD after initial macrolide treatment did not differ between PMC and CST groups (5.1 vs. 4.2 days, P = 0.085), PMC and DXC groups (4.9 vs. 5.7 days, P = 0.453), and PMC and LFX groups (4.4 vs. 5.0 days, P = 0.283). No side effects were observed in the CST, DXC, and LFX groups.
Conclusion:The change to secondary treatment did not show better efficacy compared to PMC in children with macrolide-unresponsive MP pneumonia. Further studies are needed to guide appropriate treatment in children with MP pneumonia.
-
【Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children.].
【延长大环内酯类，皮质类固醇，强力霉素和左氧氟沙星对儿童大环内酯无反应性肺炎支原体肺炎的治疗效果和安全性。】
复制标题
收藏
DOI：10.3346/jkms.2018.33.e268文章类型：杂志文章
复制DOI
译文
背景：我们旨在比较延长的大环内酯（PMC），皮质类固醇（CST），强力霉素（DXC）和左氧氟沙星（LFX）对儿童对大环内酯无反应性肺炎支原体（MP）肺炎的疗效，并评估其安全性二级治疗剂。
方法：我们回顾性分析2015年1月至2017年4月住院的MP肺炎患者的数据。临床定义大环内酯无反应性，并在大环内酯治疗后≥72小时持续发烧≥38.0°C。病例分为四类：PMC，CST，DXC和LFX。我们使用倾向评分匹配分析，通过调整比较了每组中二次治疗后的去铁时间（TTD）和初始大环内酯类药物治疗后的TTD。
结果：在1,165例MP肺炎患者中，有190例（16.3％）对大环内酯类药物无反应。 CST，DXC和LFX组在48小时内达到退热的患者比例分别为96.9％（31/33），85.7％（12/14）和83.3％（5/6）。 PMC和CST组（5.1 vs.4.2天，P = 0.085），PMC和DXC组（4.9 vs. 5.7天，P = 0.453），PMC和LFX组（4.4 vs. 5.0天，P = 0.283）。在CST，DXC和LFX组中未观察到副作用。
结论：对大环内酯无反应的MP肺炎患儿，与PMC相比，二级治疗的改变没有显示出更好的疗效。需要进一步研究以指导MP肺炎患儿的适当治疗。
方法：我们回顾性分析2015年1月至2017年4月住院的MP肺炎患者的数据。临床定义大环内酯无反应性，并在大环内酯治疗后≥72小时持续发烧≥38.0°C。病例分为四类：PMC，CST，DXC和LFX。我们使用倾向评分匹配分析，通过调整比较了每组中二次治疗后的去铁时间（TTD）和初始大环内酯类药物治疗后的TTD。
结果：在1,165例MP肺炎患者中，有190例（16.3％）对大环内酯类药物无反应。 CST，DXC和LFX组在48小时内达到退热的患者比例分别为96.9％（31/33），85.7％（12/14）和83.3％（5/6）。 PMC和CST组（5.1 vs.4.2天，P = 0.085），PMC和DXC组（4.9 vs. 5.7天，P = 0.453），PMC和LFX组（4.4 vs. 5.0天，P = 0.283）。在CST，DXC和LFX组中未观察到副作用。
结论：对大环内酯无反应的MP肺炎患儿，与PMC相比，二级治疗的改变没有显示出更好的疗效。需要进一步研究以指导MP肺炎患儿的适当治疗。
