KMID : 1035620200080020066
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Allergy Asthma & Respiratory Disease 2020 Volume.8 No. 2 p.66 ~ p.72
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Real-world treatment pattern of mycoplasma pneumonia in hospitalized children: A multicenter retrospective study
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Lee Young-Ju
Ahn Young-Min Jang Gwang-Cheon Chung Hai-Lee Chung Eun-Hee Hwang Yoon-Ha Shim Jung-Yeon
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Abstract
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Purpose: Macrolide-refractory Mycoplasma pneumoniae pneumonia (MP) has markedly increased since 2003 and corticosteroids or second-line antibiotics, such as fluoroquinolones or tetracyclines, was considered an alternative treatment modality in macrolide-refractory MP. We aimed to show the real-world treatment pattern of MP in hospitalized children and compared clinical and laboratory findings between children with and without steroid treatment.
Methods: We reviewed the medical records of 384 children diagnosed with MP from 6 hospitals in Korea from August 2015 to March 2016. We investigated the clinical, laboratory and radiologic findings, and medications used for the treatment of the subjects.
Results: The corticosteroids and second-line antibiotics were administered in 55.5% and 7.0%, respectively. The percentages of steroid administration varied from 17% to 69% in each hospital. The mean start date of corticosteroid administration was 3.4 hospital days. Patients with corticosteroid treatment had a longer length of hospital stay than those without corticosteroid. They exhibited higher rates of lobar pneumonia and pleural effusion, and required longer days until improvement in chest X-ray findings. They also had higher rates of allergic diseases and showed higher C-reactive protein levels at admission.
Conclusion: In the real-world practice studied in the 6 hospitals, corticosteroids were more frequently administered than second-line antibiotics to hospitalized children with MP. Children with corticosteroid adjuvant therapy had more severe pneumonia than those without. Randomized controlled trials are needed to make appropriate guidelines for macrolide-refractory MP.
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KEYWORD
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Mycoplasma, Pneumonia, Child, Corticosteroid, Antibiotics
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