Effect of doxycycline administered at different times on macrolide-resistant children with Mycoplasma pneumoniae pneumonia
10.12173/j.issn.2097-4922.202409039
- VernacularTitle:多西环素不同时间给药对大环内酯类耐药肺炎支原体肺炎患儿的影响
- Author:
Chufeng DAI
1
;
Fang ZHOU
;
Qin HUANG
;
Qimin SHAO
Author Information
1. 杭州市儿童医院风湿免疫肾内科(杭州 310014)
- Keywords:
Macrolide-resistant;
Mycoplasma pneumoniae;
Doxycycline;
Azithromycin;
Propensity score matching;
Glucocorticoid;
Adverse events
- From:
China Pharmacist
2024;28(11):431-437
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the impact of different dosing times of doxycycline(DOX)on children with macrolide-resistant Mycoplasma pneumoniae pneumonia(MR-MPP).Methods Clinical data of children diagnosed with MR-MPP at Hangzhou Children's Hospital from January 2022 to December 2023 were analyzed.Children were divided into three groups based on treatment regimens:the doxycycline(DOX)group,the intravenous azithromycin converted to oral DOX(ATD)group,and the intravenous azithromycin alone(AZI)group..The ATD group was further divided into ATD1 group(<3 days)and ATD2 group(>3 days)according to the duration of azithromycin treatment.Clinical symptoms of each group were compared,and propensity score matching(PSM)analysis was used for adjustment.Results A total of 156 children with MR-MPP were included in the study,with 25 in the DOX group,85 in the ATD group,and 46 in the AZI group.Compared with the ATD and AZI groups,the DOX group had a shorter hospital stay and fever duration,higher chest radiograph improvement rate,and lower glucocorticoid usage rate(P<0.05).The DOX group and ATD1 group had lower hospital stays,post-treatment fever durations,and glucocorticoid usage rates than the ATD2 group,and higher 96-hour fever resolution rates and chest X-ray improvement rates than the ATD2 group(P<0.05).The DOX group had a higher fever resolution rate within 72 hours compared to the ATD1 and ATD2 groups(P<0.05).PSM analysis showed that the DOX-ATD1 group had a lower hospital stay,post-treatment fever duration,and glucocorticoid usage rate than the ATD2 group,and a higher 72-hour fever resolution rate than the ATD2 group(all P<0.05).No adverse reactions related to DOX were observed during the treatment period.Conclusion Early oral administration of DOX within 72 hours can significantly improve the clinical efficacy in children with MR-MPP.