Zhao Qian, Sang Xu, Gao Ding, Zhang Zhen, Xuan Aili, Peng Wansheng
Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical University, No. 287, Changhuai Road, Longzihu District, Bengbu, 233004, Anhui Province, People's Republic of China.
Department of Cardiology, Second Affiliated Hospital of Bengbu Medical University, Bengbu, 233000, People's Republic of China.
Clin Exp Med. 2025 Jul 22;25(1):259. doi: 10.1007/s10238-025-01793-x.
This study evaluated the efficacy and safety of doxycycline in treating Severe Mycoplasma pneumoniae Pneumonia (SMPP) in children under eight years old through clinical analysis and meta-analysis. A total of 92 pediatric SMPP cases were divided into a doxycycline treatment group (44 cases) and a macrolides control group (48 cases). Compared to the control group, the doxycycline group exhibited significantly shorter cough relief time (5.4 ± 1.2 vs. 7.2 ± 1.6 days, p < 0.05) and pulmonary rale resolution time (6.2 ± 1.3 vs. 8.0 ± 1.7 days, p < 0.05). The overall treatment efficacy rate was higher in the doxycycline group (88.6% vs. 75.0%, p < 0.05). No significant differences were found in fever resolution time or hospitalization duration (p > 0.05). Safety analysis revealed comparable adverse event rates between groups (18.2% vs. 16.7%, p > 0.05), primarily mild rash and gastrointestinal discomfort, with no tooth discoloration observed. The meta-analysis confirmed the advantages of doxycycline, demonstrating superior treatment efficacy (RR: 0.68, 95% CI: 0.58-0.79), shorter fever resolution (MD: - 1.5 days, 95% CI: - 2.3 to - 0.7), and faster cough and pulmonary rale resolution. Adverse events were similar across groups. These findings highlight doxycycline's clinical efficacy and safety in SMPP treatment, providing strong evidence for its application in pediatric practice.
本研究通过临床分析和荟萃分析，评估了多西环素治疗8岁以下儿童重症肺炎支原体肺炎（SMPP）的疗效和安全性。共92例儿童SMPP病例被分为多西环素治疗组（44例）和大环内酯类对照组（48例）。与对照组相比，多西环素组咳嗽缓解时间显著缩短（5.4±1.2天 vs. 7.2±1.6天，p<0.05），肺部啰音消失时间也显著缩短（6.2±1.3天 vs. 8.0±1.7天，p<0.05）。多西环素组的总体治疗有效率更高（88.6% vs. 75.0%，p<0.05）。发热消退时间和住院时间无显著差异（p>0.05）。安全性分析显示，两组间不良事件发生率相当（18.2% vs. 16.7%，p>0.05），主要为轻度皮疹和胃肠道不适，未观察到牙齿变色。荟萃分析证实了多西环素的优势，显示出更高的治疗效果（RR：0.68，95%CI：0.58 - 0.79）、更短的发热消退时间（MD：-1.5天，95%CI：-2.3至-0.7）以及更快的咳嗽和肺部啰音消退。各治疗组间不良事件相似。这些研究结果突出了多西环素在SMPP治疗中的临床疗效和安全性，为其在儿科临床实践中的应用提供了有力证据。
