Yang Dehua, Chen Linghong, Chen Zhimin
Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China.
The First People's Hospital of Wenling, Wenling, Zhejiang, P.R. China.
PLoS One. 2018 Jan 29;13(1):e0191951. doi: 10.1371/journal.pone.0191951. eCollection 2018.
Mycoplasma pneumoniae infection is a major cause of community-acquired pneumonia in children. We performed a retrospective study to evaluate the clinical impact of the timing of azithromycin treatment in children with Mycoplasma pneumoniae pneumonia in high macrolide-resistant prevalence settings.
A total of 623 patients were enrolled in this study and were divided into 2 groups according to the timing of azithromycin therapy. Children who received azithromycin within 3 days (72 hours) after the onset of Mycoplasma pneumoniae pneumonia were classified into the early azithromycin treatment group (n = 174), whereas the late azithromycin treatment group (n = 449) comprised children treated with azithromycin more than 72 hours after symptom onset. We evaluated clinical prognosis according to demographic, clinical and laboratory characteristics. Although the early azithromycin treatment group exhibited a longer fever duration after azithromycin administration (7.17±4.12 versus 4.82±3.99 days, P<0.01), the total fever duration exhibited no significant difference (9.02±4.58 versus 9.57±4.91 days, P = 0.212). After azithromycin therapy, the two groups exhibited no significant differences with respect to improvements in the laboratory and radiological findings (all P>0.05).
The timing of azithromycin treatment is not associated with the clinical prognosis of Mycoplasma pneumoniae pneumonia in children in high macrolide-resistant Mycoplasma pneumoniae prevalence settings.
肺炎支原体感染是儿童社区获得性肺炎的主要病因。我们进行了一项回顾性研究,以评估在大环内酯类耐药率高的环境中,阿奇霉素治疗时机对肺炎支原体肺炎患儿的临床影响。
本研究共纳入623例患者,根据阿奇霉素治疗时机分为2组。在肺炎支原体肺炎发病后3天(72小时)内接受阿奇霉素治疗的儿童被归为阿奇霉素早期治疗组(n = 174),而阿奇霉素晚期治疗组(n = 449)包括症状出现72小时后接受阿奇霉素治疗的儿童。我们根据人口统计学、临床和实验室特征评估临床预后。虽然阿奇霉素早期治疗组在使用阿奇霉素后发热持续时间更长(7.17±4.12天对4.82±3.99天,P<0.01),但总发热持续时间无显著差异(9.02±4.58天对9.57±4.91天,P = 0.212)。阿奇霉素治疗后,两组在实验室和影像学检查结果改善方面无显著差异(所有P>0.05)。
在肺炎支原体大环内酯类耐药率高的环境中,阿奇霉素治疗时机与儿童肺炎支原体肺炎的临床预后无关。