Allergy Asthma Respir Dis.  2020 Apr;8(2):66-72. 10.4168/aard.2020.8.2.66.

Real-world treatment pattern of mycoplasma pneumonia in hospitalized children: A multicenter retrospective study

Affiliations
  • 1Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Pediatrics, Eulji University Eulji General Hospital, Seoul, Korea
  • 3Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
  • 4Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea
  • 5Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
  • 6Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea

Abstract

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.

Keyword

Mycoplasma; Pneumonia; Child; Corticosteroid; Antibiotics
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