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在大环内酯类耐药率高的情况下,阿奇霉素治疗时机与儿童支原体肺炎的临床预后无关。

The timing of azithromycin treatment is not associated with the clinical prognosis of childhood Mycoplasma pneumoniae pneumonia in high macrolide-resistant prevalence settings.

作者信息

Yang Dehua, Chen Linghong, Chen Zhimin

机构信息

Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China.

The First People's Hospital of Wenling, Wenling, Zhejiang, P.R. China.

出版信息

PLoS One. 2018 Jan 29;13(1):e0191951. doi: 10.1371/journal.pone.0191951. eCollection 2018.

Abstract

BACKGROUND

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.

METHODS AND FINDINGS

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).

CONCLUSION

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.

摘要

背景

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。

方法与结果

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)。

结论

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。

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