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The clinical efficacy of azithromycin combined with different-dose methylprednisolone therapy for refractory mycoplasma pneumoniae pneumonia in children / 国际儿科学杂志
International Journal of Pediatrics ; (6): 420-425, 2021.
Article in Chinese | WPRIM | ID: wpr-907251
ABSTRACT

Objective:

To investigate the efficacy of azithromycin combined with different-dose methylprednisolone therapy for refractory mycoplasma pneumoniae pneumonia(RMPP)in children.

Methods:

Two hundred and twenty cases of RMPP admitted to Chengdu Women′s and Children′s Central Hospital between January 2014 and December 2019 were selected.They were treated with azithromycin combined with 1~2 mg/(kg·d)(low-dose)of methylprednisolone for 3 days, then they were divided into 2 groups, 152 cases with effective treatment in the control group A(effective group), 68 cases with ineffective treatment in observation group B(ineffective group). Among group B, according to the IgG, IgM and IgA as defined in Zhu Futang Practice of Pediatrics, 45 cases with normal immunity named normal-immune group B, change methylprednisolone dose to 10~30 mg/(kg·d)(high-dose)for 3 days, and 23 cases with low immunity named weakened-immune group B, change methylprednisolone dose to 10~30 mg/(kg·d)for 3 days and give immunomodulator therapy, that is human immunoglobulin for intravenous injection(IVIG)200 mg/(kg·d)for 3 days.After treatment, duration of fever, lung inflammation, extrapulmonary complications, hospitalization days and other indicators were compared.

Results:

Comparison between group A and group B, the lung rale absorption time[(11.32±3.62)d vs(10.00±2.32)d], lung consolidation absorption rate(64.10% vs 83.33%), pulmonary atelectasis retentive rate(52.38% vs 82.60%), effusion absorption rate(66.67% vs 100.00% ), the incidence rate of extrapulmonary complications(38.82% vs 25.00%), the disappearance time of complications[(10.96±2.98)d vs(8.94±2.86)d], the average hospitalization stay[(12.30±3.56)d vs(11.25±3.84)d]were significantly different( P<0.05). Comparison between normal-immune group B and weakened-immune group B after giving high doses of methylprednisolone, the fever dropped time[(10.51±3.26)h vs(8.60±3.31)h], the lung rale absorption time[(10.51±2.24)d vs(9.00±2.19)d], lung consolidation absorption rate(72.00% vs 100.00%), the average hospitalization stay[(12.00±3.96)d vs(9.78±3.19)d]were significantly different( P<0.05).

Conclusion:

Compared to low-dose of methylprednisolone, azithromycin combined with high-dose methylprednisolone therapy is better for RMPP.For the children with weakened immunity, better curative effect was obtained by IVIG.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: International Journal of Pediatrics Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: International Journal of Pediatrics Year: 2021 Type: Article