Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children
Identifieur interne : 000686 ( Main/Exploration ); précédent : 000685; suivant : 000687Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children
Auteurs : Seok Gyun Ha [Corée du Sud] ; Kyung Jin Oh [Corée du Sud] ; Kwang-Pil Ko [Corée du Sud] ; Yong Han Sun [Corée du Sud] ; Eell Ryoo [Corée du Sud] ; Hann Tchah [Corée du Sud] ; In Sang Jeon [Corée du Sud] ; Hyo Jeong Kim [Corée du Sud] ; Jung Min Ahn [Corée du Sud] ; Hye-Kyung Cho [Corée du Sud]Source :
- Journal of Korean Medical Science [ 1011-8934 ] ; 2018.
Abstract
We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive
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.
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,
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.
Url:
DOI: 10.3346/jkms.2018.33.e268
PubMed: 30344461
PubMed Central: 6193889
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive <italic>Mycoplasma pneumoniae</italic> Pneumonia in Children</title><author><name sortKey="Ha, Seok Gyun" sort="Ha, Seok Gyun" uniqKey="Ha S" first="Seok Gyun" last="Ha">Seok Gyun Ha</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Oh, Kyung Jin" sort="Oh, Kyung Jin" uniqKey="Oh K" first="Kyung Jin" last="Oh">Kyung Jin Oh</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ko, Kwang Pil" sort="Ko, Kwang Pil" uniqKey="Ko K" first="Kwang-Pil" last="Ko">Kwang-Pil Ko</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Preventive Medicine, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sun, Yong Han" sort="Sun, Yong Han" uniqKey="Sun Y" first="Yong Han" last="Sun">Yong Han Sun</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ryoo, Eell" sort="Ryoo, Eell" uniqKey="Ryoo E" first="Eell" last="Ryoo">Eell Ryoo</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tchah, Hann" sort="Tchah, Hann" uniqKey="Tchah H" first="Hann" last="Tchah">Hann Tchah</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jeon, In Sang" sort="Jeon, In Sang" uniqKey="Jeon I" first="In Sang" last="Jeon">In Sang Jeon</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Hyo Jeong" sort="Kim, Hyo Jeong" uniqKey="Kim H" first="Hyo Jeong" last="Kim">Hyo Jeong Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ahn, Jung Min" sort="Ahn, Jung Min" uniqKey="Ahn J" first="Jung Min" last="Ahn">Jung Min Ahn</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Hye Kyung" sort="Cho, Hye Kyung" uniqKey="Cho H" first="Hye-Kyung" last="Cho">Hye-Kyung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30344461</idno><idno type="pmc">6193889</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193889</idno><idno type="RBID">PMC:6193889</idno><idno type="doi">10.3346/jkms.2018.33.e268</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">000633</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000633</idno><idno type="wicri:Area/Pmc/Curation">000633</idno><idno 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last="Ha">Seok Gyun Ha</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Oh, Kyung Jin" sort="Oh, Kyung Jin" uniqKey="Oh K" first="Kyung Jin" last="Oh">Kyung Jin Oh</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ko, Kwang Pil" sort="Ko, Kwang Pil" uniqKey="Ko K" first="Kwang-Pil" last="Ko">Kwang-Pil Ko</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Preventive Medicine, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sun, Yong Han" sort="Sun, Yong Han" uniqKey="Sun Y" first="Yong Han" last="Sun">Yong Han Sun</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ryoo, Eell" sort="Ryoo, Eell" uniqKey="Ryoo E" first="Eell" last="Ryoo">Eell Ryoo</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tchah, Hann" sort="Tchah, Hann" uniqKey="Tchah H" first="Hann" last="Tchah">Hann Tchah</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jeon, In Sang" sort="Jeon, In Sang" uniqKey="Jeon I" first="In Sang" last="Jeon">In Sang Jeon</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Hyo Jeong" sort="Kim, Hyo Jeong" uniqKey="Kim H" first="Hyo Jeong" last="Kim">Hyo Jeong Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ahn, Jung Min" sort="Ahn, Jung Min" uniqKey="Ahn J" first="Jung Min" last="Ahn">Jung Min Ahn</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Hye Kyung" sort="Cho, Hye Kyung" uniqKey="Cho H" first="Hye-Kyung" last="Cho">Hye-Kyung Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Pediatrics, Gachon University College of Medicine, Incheon,<country>Korea</country>.</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Korean Medical Science</title><idno type="ISSN">1011-8934</idno><idno type="eISSN">1598-6357</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive <italic>Mycoplasma pneumoniae</italic> (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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, <italic>P</italic> = 0.085), PMC and DXC groups (4.9 vs. 5.7 days, <italic>P</italic> = 0.453), and PMC and LFX groups (4.4 vs. 5.0 days, <italic>P</italic> = 0.283). No side effects were observed in the CST, DXC, and LFX groups.</p></sec><sec><title>Conclusion</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Narita, M" uniqKey="Narita M">M Narita</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Youn, Ys" uniqKey="Youn Y">YS Youn</name></author><author><name sortKey="Lee, Ky" uniqKey="Lee K">KY Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Atkinson, Tp" uniqKey="Atkinson T">TP Atkinson</name></author><author><name sortKey="Balish, Mf" uniqKey="Balish M">MF Balish</name></author><author><name sortKey="Waites, Kb" uniqKey="Waites K">KB Waites</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eun, Bw" uniqKey="Eun B">BW Eun</name></author><author><name sortKey="Kim, Nh" uniqKey="Kim N">NH Kim</name></author><author><name sortKey="Choi, Eh" uniqKey="Choi E">EH 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Volovitz</name></author><author><name sortKey="Shkap, R" uniqKey="Shkap R">R Shkap</name></author><author><name sortKey="Amir, J" uniqKey="Amir J">J Amir</name></author><author><name sortKey="Calderon, S" uniqKey="Calderon S">S Calderon</name></author><author><name sortKey="Varsano, I" uniqKey="Varsano I">I Varsano</name></author><author><name sortKey="Nussinovitch, M" uniqKey="Nussinovitch M">M Nussinovitch</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Ha, Seok Gyun" sort="Ha, Seok Gyun" uniqKey="Ha S" first="Seok Gyun" last="Ha">Seok Gyun Ha</name></noRegion><name sortKey="Ahn, Jung Min" sort="Ahn, Jung Min" uniqKey="Ahn J" first="Jung Min" last="Ahn">Jung Min Ahn</name><name sortKey="Cho, Hye Kyung" sort="Cho, Hye Kyung" uniqKey="Cho H" first="Hye-Kyung" last="Cho">Hye-Kyung Cho</name><name sortKey="Jeon, In Sang" sort="Jeon, In Sang" uniqKey="Jeon I" first="In Sang" last="Jeon">In Sang Jeon</name><name sortKey="Kim, Hyo Jeong" sort="Kim, Hyo Jeong" uniqKey="Kim H" first="Hyo Jeong" last="Kim">Hyo Jeong Kim</name><name sortKey="Ko, Kwang Pil" sort="Ko, Kwang Pil" uniqKey="Ko K" first="Kwang-Pil" last="Ko">Kwang-Pil Ko</name><name sortKey="Oh, Kyung Jin" sort="Oh, Kyung Jin" uniqKey="Oh K" first="Kyung Jin" last="Oh">Kyung Jin Oh</name><name sortKey="Ryoo, Eell" sort="Ryoo, Eell" uniqKey="Ryoo E" first="Eell" last="Ryoo">Eell Ryoo</name><name sortKey="Sun, Yong Han" sort="Sun, Yong Han" uniqKey="Sun Y" first="Yong Han" last="Sun">Yong Han Sun</name><name sortKey="Tchah, Hann" sort="Tchah, Hann" uniqKey="Tchah H" first="Hann" last="Tchah">Hann Tchah</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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