Mycoplasma Pneumonia In Children Research Articles

Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta-analysis of randomized controlled trials.

What is known and objectiveAn increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta‐analysis.MethodsRandomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data.ResultsA total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA.What is new and conclusionYanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.

Epidemiological and clinical analysis of community-acquired Mycoplasma pneumonia in children from a Spanish population, 2010–2015

Introduction and objectivesMycoplasma pneumoniae (MP) is one of the most common etiological agents of community-acquired pneumonia (CAP) in children. We aimed to describe the clinical and epidemiological characteristics, treatment and outcome of children diagnosed with community-acquired MP pneumonia (CAMP) in a tertiary hospital in Valencia, Spain. Material and methodsMedical records of children <14 years with CAMP were retrospectively reviewed from January 2010 to December 2015. Patients with radiological evidence of pneumonia and microbiological confirmation of MP (PCR from nasopharyngeal swab and/or serum specific IgM) were considered CAMP. ResultsOne hundred and sixty two children were diagnosed with CAMP; median age 6 years (IQR: 4–9). The positive MP test rate among children with CAP progressively increased with age as did the empirical use of macrolides. There were two peaks of cases in 2011 and in 2015, being July, August, November and December the seasons with the higher number of cases. The most frequent radiological pattern was segmental infiltrate (62.3%) and 22 (13.6%) children had pleural effusion. It was noteworthy the mild symptomatology and low levels of inflammatory parameters that children with CAMP had. A macrolide was empirically initiated in 68.5% of cases. Hospital admission rate was inversely proportional to patient's age. ConclusionsAccording to this study, older, less symptomatic patients and with lower inflammatory parameters had the greatest rate of MP infection among children with CAP and thus they could benefit of empiric macrolide therapy. Therefore, knowing the epidemiology of a geographical area may be important for the management of CAP in children.

Epidemiological and clinical analysis of community-acquired Mycoplasma pneumonia in children from a Spanish population, 2010-2015

ResumenIntroducción y objetivosMycoplasma pneumoniae (MP) es uno de los agentes etiológicos más comunes de las neumonías adquiridas en la comunidad (NAC) en niños. Objetivo: describir las características clínicas y epidemiológicas, tratamiento y evolución de los pacientes con NAC por MP (NACM) en un hospital terciario de Valencia, España.Material y métodosSe revisaron retrospectivamente las historias clínicas de los niños < 14 años con NACM entre enero de 2010 y diciembre de 2015. Los pacientes con evidencia radiológica de neumonía y confirmación microbiológica de MP (PCR de exudado nasofaríngeo y/o anticuerpos IgM específicos frente a MP) se consideraron NACM.ResultadosUn total de 162 pacientes se diagnosticaron de NACM; mediana de edad de 6 años (rango intercuartílico: 4-9 años). La proporción de pruebas positivas para MP en pacientes con NAC, así como el uso empírico de macrólidos, aumentó progresivamente con la edad. Hubo un pico de casos en 2011 y en 2015, con un máximo de casos en julio, agosto, noviembre y diciembre. El patrón radiológico más frecuente fue el infiltrado segmentario (62,3%), mientras que 22 (13,6%) presentaron derrame pleural. Los niños con NACM desarrollaron una clínica leve, con poca elevación de parámetros inflamatorios. Se inició tratamiento empírico con un macrólido en el 68,5% de los casos. La necesidad de ingreso hospitalario fue inversamente proporcional a la edad del paciente.ConclusionesSegún este estudio, los niños con NAC de mayor edad tuvieron la mayor proporción de infección por MP, siendo poco sintomáticos y con escasa elevación de parámetros inflamatorios, pudiéndose beneficiar del tratamiento empírico con macrólidos. Por consiguiente, conocer la epidemiología de un área geográfica podría ser importante para el abordaje de las NAC en niños.

Effect of mucosolvan irrigation via bronchoscopy on refractory mycoplasma pneumonia in children

目的 观察盐酸氨溴索(沐舒坦)经纤维支气管镜灌洗对儿童难治性肺炎支原体肺炎的疗效。 方法 采用随机对照方法，将43例难治性肺炎支原体肺炎患儿分为试验组和对照组，试验组25例，平均年龄(5.56±3.28)岁，对照组18例，平均年龄(6.44±2.73)岁，在常规药物治疗儿童难治性肺炎支原体肺炎的基础上，两组在病程2～3周行纤维支气管镜检查，试验组在常规生理盐水灌洗的基础上应用沐舒坦灌洗病变部位，对照组应用常规生理盐水灌洗病变部位。比较两组患儿的住院天数、做镜后发热天数及咳嗽情况等一般临床表现，咳嗽症状改善采用评分方式，且1周后复查胸部CT及纤维支气管镜，比较两组的疗效差别。 结果 试验组与对照组在性别、年龄、做镜前病程、发热天数差异无统计学意义(P>0.05)，做镜后试验组较对照组咳嗽明显改善，做镜1周后，试验组胸部CT总有效率92%高于对照组72.3%，差异有统计学意义(P 0.05)，两组住院天数无显著差异[(15.16±7.66)vs(14.06±5.48)](P>0.05)。 结论 经纤维支气管镜沐舒坦灌洗治疗RMPP可以有效改善患儿的咳嗽情况，促进肺部炎症的吸收。

The application of high quality nursing mode in the treatment of mycoplasma pneumonia in children

Objective To explore the effect of high quality nursing model in the treatment of mycoplasma pneumonia in children. Methods From January 2014 to December 2016, a total of 100 cases of children with bronchopneumonia were selected as the research objects and were randomly divided into observation group and control group, 50 cases of each group.Patients in the control group received routine nursing, and patients in the observation group received clinical pathway nursing of bronchopneumonia.The hospitalization cost, length of stay and parents' satisfaction were observed and compared between the two groups. Results Compared with the control group, there were statistically significant differences in the duration of antipyretic, cough, sputum cessation, lung murmur disappearance, and hospitalization (P 0.05). Conclusion High quality paediatric nursing can significantly improve the nursing satisfaction of children and their families with mycoplasma pneumoniae, shorten the treatment time, and have the value of further promotion and application in clinical practice. Key words: Quality care; Children; Mycoplasma peumonia; Clinic pathway

Efficacy and adverse reaction of azithromycin sequential therapy for the treatment of mycoplasma pneumonia in children

Objective To investigate the efficacy and adverse reactions of azithromycin sequential therapy for the treatment of children with mycoplasma pneumonia. Methods 84 children with mycoplasma pneumonia were randomly divided into study group and control group according to the digital table, with 42 cases in each group.The study group was given azithromycin treatment, and the control group was given erythromycin treatment.The clinical curative effect and adverse reaction were compared between the two groups. Results The total effective rate of the study group (97.62%) was significantly higher than that of the control group (76.19%), and the difference was statistically significant (χ2=11.95, P<0.05). The pyretolysis time[(3.78±1.57)d], cough improvement time[(3.29±0.74) d], rale disappearance time[(5.88±2.35)d], average hospitalization time[(8.89±1.76)d]of the study group were significantly shorter than those of the control group[(4.49±1.71)d, (4.28±0.77)d, (7.69±2.54)d, (10.05±2.27)d], and the differences were statistically significant (t=2.01, 6.33, 3.29, 2.46, all P<0.05). The incidence rate of adverse reactions such as nausea, abdominal distention, abdominal discomfort, local injection pain, rash, elevated alanine aminotransferase of the study group (4.76%) was significantly lower than that of the control group (19.05%), and the difference was statistically significant (χ2=4.86, P<0.05). Conclusion Azithromycin sequential therapy is effective in the treatment of children with mycoplasma pneumonia.It can effectively shorten the disappearance time of clinical symptoms and signs, and average hospitalization time, and has low incidence rate of adverse reactions.It is worthy of clinical use. Key words: Mycoplasma pneumonia; Azithromycin; Children; Curative effect; Adverse reaction

Clinical efficacy of erythromycin combined with azithromycin in the treatment of children with mycoplasma pneumonia

Objective To explore the clinical efficacy of erythromycin combined with azithromycin in the treatment of mycoplasma pneumonia in children. Methods 98 children with mycoplasma pneumonia were selected.According to the digital chart, the patients were randomly divided into the observation group and control group, with 49 cases in each group.On the basis of routine treatment, the control group was treated with azithromycin, and the observation group received erythromycin combined with azithromycin.After treatment, the disappearance time of the disease (fever, cough, pulmonary rale), hospitalization time and adverse reactions were observed in the two groups, and the clinical efficacy of the two groups was compared. Results The total effective rate in the observation group was 95.91%, which was significantly higher than that in the control group (79.5%), and the difference was statistically significant (χ2=4.721, P 0.05). Conclusion Compared with azithromycin alone, erythromycin combined with azithromycin is effective and safe in the treatment of children with mycoplasma pneumonia.It is beneficial to shorten the course of treatment and improve the efficacy, and is worthy of further popularization and application. Key words: Children; Mycoplasma pneumoniae; Erythromycin; Azithromycin

Clinical analysis of risk factors in refractory mycoplasma pneumonia in children

Purpose: Refractory Mycoplasma pneumonia (RMP) has been increasing not only in Korea but worldwide. We investigated the inci dence of M. pneumonia resistant to macrolides and risk factors for RMP. Methods: From October 2015 to May 2016, 62 pediatric patients who were admitted due to pneumonia diagnosed on the basis of chest x-ray with respiratory symptoms and positive for M. pneumoniae in polymerase chain reaction with no evidence of other bac terial or viral infections were included. Sequence analysis of the 23S rRNA gene in M. pneumoniae was performed to identify macro lide resistance. Patients with congenital anomalies, history of pulmonary disease, and unclear information on antibiotic use were ex cluded. Results: Mutations in the 23S rRNA gene were detected in 50 of 62 patients (80.6%). Risk factors were analyzed in only 45 patients. The RMP group consisted of 26 patients (57.8%) who had fever lasting more than 5 days and deteriorating chest x-ray findings. The lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels were significantly higher in the RMP group than in the non-RMP group (LDH: 300±79 U/L vs. 469±206 U/L, CRP: 4.9±4.3 mg/dL vs. 2.5±1.7 mg/dL; P=0.04 vs. P=0.026). In univariate analysis, the RMP group was significantly associated with 23S rRNA gene mutation, lobar pneumonia, and pleural effusion (odds ration [OR]: 10.8, 4.1, 5.3; P=0.004, P=0.036, P=0.046). The presence of macrolide resistance was found to be only a significant risk factor in lo gistic regression (OR; 8.827; 95% confidence interval, 1.376-56.622; P=0.022). Conclusion: Macrolide resistance was a significant risk factor in patients with RMP and identification of macrolide resistance might be helpful in predicting RMP and establishing target therapy for RMP. (Allergy Asthma Respir Dis 2018;6:62-67)

Diagnostic value of serum IgM enzyme-linked immunosorbent assays in polymerase chain reaction-positive Mycoplasma pneumonia in children

Diagnostic value of serum IgM enzyme-linked immunosorbent assays in polymerase chain reaction-positive Mycoplasma pneumonia in children

Pattern and Significance of Asymptomatic Elevation of Liver Enzymes in Mycoplasma Pneumonia in Children.

Mycoplasma infection is on the rise in recent times. It usually infects any system, including liver. This study aims to show the significance of elevated liver enzymes in mycoplasma pneumonia and to have a look at future prospects. This is a single-center retrospective study involving 105 children serologically positive for mycoplasma IgM and IgG antibodies and 50 with community-acquired pneumonia caused by organisms other than mycoplasma and Epstein-Barr virus from June 2015 to June 2016 and all without prior liver disease. The patients were followed after 10 days (7-14 days). The liver enzymes were significantly elevated in Mycoplasma pneumoniae infection. The mean levels of alanine transaminase and aspartate transaminase were 39.3 and 32.5 IU/L, respectively. There was a seasonal variation during the months of September and February. Liver involvement in mycoplasma pneumonia is mostly a benign condition and asymptomatic. It is insisted that children with continued elevation should be followed conservatively to avoid unnecessary diagnostic procedures in the future.

Value of clinical signs in the identification of Mycoplasma pneumonia in community acquired pneumonia in children

To evaluate the value of clinical signs in the identification of Mycoplasma pneumonia in children's community acquired pneumonia. We searched the Cochrane library, PubMed, CNKI, Wan Fang and VIP databases. According to the inclusion and exclusion criterias, we selected and extracted the related information in the literature. According to the QUADAS evaluation system, we established the quality evaluation standard to evaluate the quality of the included studies and analyzed the difference of the clinical manifestations between Mycoplasmae pneumoniae and non-Mycoplasma pneumoniae in children's community acquired pneumonia. We used the RevMan 5.3 software to do the meta-analysis and collected the data according to the requirements. We calculated the pooled sensitivities, specificities and 95%CIs. Then we calculated the negative and positive likelihood ratio, the ratio of the diagnosis and the pre-/post-test probabilities with 95% CIs. A total of 11 articles were included in the literature. In summary, the cases of the clinical signs of true positive (TP) and false positive (FP) were as follows : chest pain: TP: 287, FP: 1090; rales: TP: 1906, FP: 6886; headache: TP: 590, FP: 2051; pleural effusion: TP: 10, FP: 16; consolidation: TP: 75, FP: 83; emphysema: TP: 443, FP: 116. The pooled sensitivity, the pooled specificity, the diagnostic ratio (DOR) and 95% CI were: chest pain: pooled sensitivity: 0.12, 95% CI: 0.10-0.13, pooled specificity: 0.89, 95% CI: 0.88-0.90, DOR: 1.05, 95% CI: 0.92-1.21; rales: pooled sensitivity: 0.66, 95% CI: 0.64, 0.67, pooled specificity: 0.36, 95% CI: 0.35, 0.37, DOR: 1.12, 95% CI: 1.02, 1.22; headache: pooled sensitivity: 0.23, 95% CI: 0.21-0.25, pooled specificity: 0.80, 95%CI: 0.79-0.80, DOR: 1.16, 95%CI: 1.05-1.29; pleural effusion: pooled sensitivity: 0.04, 95% CI: 0.02, 0.08, pooled specificity: 0.98, 95% CI: 0.96, 0.99, DOR: 1.28, 95% CI: 0.56, 2.89; consolidation: pooled sensitivity: 0.32, 95% CI: 0.26, 0.39, pooled specificity: 0.87, 95% CI: 0.84, 0.90, DOR: 1.88, 95% CI: 1.23, 2.90; emphysema: pooled sensitivity: 0.22, 95% CI: 0.17, 0.29, pooled specificity: 0.73, 95% CI: 0.69, 0.77, DOR: 1.05, 95% CI: 0.68, 1.61. The value of clinical symptoms and signs in the identification of mycoplasma pneumonia in children's community acquired pneumonia was not significant. Although the clinical symptoms/signs of chest pain, headache, rales and chest X-ray manifestations of pleural effusion, consolidation, emphysema could suggest Mycoplasma pneumoniae infection, the presence or absence of any clinical signs were not positive or negative indicators for the identification of Mycoplasma pneumoniae infections.

Clinical features according to chest radiologic patterns ofMycoplasmapneumonia in children

Background: Clinical differences in Mycoplasma pneumonia (MP) in children and adolescent patients according to abnormal infiltrate patterns on the chest X-ray were compared. Methods: From 2012 to 2015, patients (n=336) diagnosed with MP at Yeungnam University Medical Center have been classified as eiher lobar pneumonia or bronchopneumonia based on the infilterate patterns observed on chest X-ray. Cases were analyzed retrospectively for gender, age, seasonal incidence rate, main symptoms (fever duration, extrapulmonary symptoms), and laboratory results, including white blood cell count, hemoglobin, platelets, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as concurrent respiratory virus infection. Results: The following results were observed. First, lobar pneumonia affected 22.0% of all MP patients and was the most common in preschool children, with a high incidence rate in November and December. Second, lobar pneumonia had a longer fever duration than bronchopneumonia (p<0.001), and also showed significantly higher platelets (336.8 vs. 299.1 k/μL, p=0.026), ESR(46.3 vs. 26.0mm/hr, p<0.001) and CRP (4.86 vs. 2.18mg/dL, p=0.001). Third, viral co-infection was more common in bronchopneumonia (p=0.017), affecting 66.7% of infants and toddlers (p=0.034). Finaly, lobar consolidation was most common in both lower lobes. Conclusion: MP in children has increased in younger age groups, and the rate of lobar pneumonia with severe clinical symptoms is higher in older children.

The curative effect of Azithromycin Sequential Therapy in the treatment of mycoplasma pneumonia in children

Objective To observe the clinical efficacy and safety of Azithromycin Sequential Therapy in the treatment of mycoplasma pneumonia for children. Methods 112 children with mycoplasma pneumonia were randomly divided into observation group and control group, each 56 cases. The observation group was treated with Azithromycin Sequential Therapy in the treatment, while the control group was treated with erythromycin lactobionate anti infection treatment. The clinical efficacy was compared between two groups after treatment, the clinical symptoms disappeared time and drug adverse reaction occurred the situation. Results The total effective rate of the observation group was 96.43%,which was significantly higher than 80.36%of the control group, the difference was statistically significant(χ2=7.04,P<0.05). The fever, cough, pulmonary rales disappearance time of the observation group were(3.74±1.58)d,(3.24±0.47)d,(5.58±2.23)d,which were significantly shorter than(4.68±1.71)d,(4.64±0.97)d,(7.82±2.70)d of the control group(t=4.27,4.68,4.59,all P<0.05).The gastrointestinal reactions,local pain,rash,the elevation of ALT of the observation group were significantly lower than the control group, the difference was statistically significant(χ2=4.26,7.04,7.03,5.23,all P<0.05). Conclusion Azithromycin Sequential Therapy for the treatment of mycoplasma pneumonia in children has the advantages of good clinical efficacy, fast effect, high safety. Key words: Mycoplasma pneumonia; Azithromycin; Erythromycin; Sequential therapy

Analysis of the related risk factors of severe mycoplasma pneumonia in children

Objective To explore the related risk factors of severe mycoplasma pneumonia in children.Methods 86 children with mycoplasma pneumonia were selected as the observation group.At the same time,30 normal children were selected as the control group.The observation group included 33 cases of mild mycoplasma pneumo nia(A group) and 53 cases of severe mycoplasma pneumonia(B group).The clinical data of the three groups were ret rospectively analyzed,and the related risk factors of severe mycoplasma pneumonia in children were analyzed.Results The risk factors of severe mycoplasma pneumonia in children were age ＞ 5 years (x2 =28.776,P ＜ 0.05),immunoglobulin IgG(x2 =3.004,P ＜ 0.05),immunoglobulin IgM (x2 =2.147,P ＜ 0.05),immunoglobulin IgA (x2 =2.036,P ＜ 0.05),WBC (x2 =6.119,P ＜ 0.05),neutrophil percentage (x2 =8.374,P ＜ 0.05),the positive rate of CD8(x2 =11.665,P＜0.05),the positive rate of CD4(x2 =12.901,P＜0.05).Conclusion For children with risk factors of severe mycoplasma pneumonia should be early diagnosed,prevented and treated,thereby reducing the burden on patients. Key words: Pneumonia, mycoplasma; Risk factors ; Child

The Efficacy of Glucocorticoid on Macrolide Resistant Mycoplasma Pneumonia in Children

Mycoplasma pneumoniae (MP) is a common etiology of pediatric and adult community-acquired pneumonia that represents 10%-40% of cases;1-3 however, the immunopathogenesis of MP in humans is poorly understood. The role of cell-mediated immunity in MP infections is controversial. Both human infection tissue and animal model lung tissue are consistent in demonstrating mononuclear perilumenal infiltrates. Animal model studies have found hyperaccentuated reactions after repeated infection that is also mimicked by repeated exposure to non-viable microbe.4

Analysis of the effect of azithromycin combined with the glucocorticoid for the mycoplasma pneumonia in children

Objective To investigate the clinical effects of azithromycin combined with glucocorticoid for the mycoplasma pneumonia in children.Methods 124 children with mycoplasma pneumonia were randomly divided into the study group and the control group with 62 cases in each group.On the basis of the routine symptomatic treatment,the control group was given azithromycin(10mg · kg-1 · d-1) and the study group was treated with azithromycin and hydrocortisone sodium succinate (0.2mg/kg) in the first five days,then stop giving hydrocortisone sodium succinate.The total course was two weeks.Results The study group of children with cough,fever and pulmonary rales disappeared significantly shorter than the control group.Comparison of clinical efficacy,the study group effective rate was 95.2％,the control group was 83.9％,the difference was statistically significant (P ＜ 0.05).Study group had 9 cases of adverse reactions,the control group had 14 cases of adverse reactions,the difference was statistically significant (P ＜ 0.05).Conclusion Glucocorticoid combined with azithromycin is used to treat children with mycoplasma pneumoniae pneumonia,which can improve the therapeutic efficacy and shorten treatment time.It is a better choice of clinical treatment for mycoplasma pneumoniae pneumonia in children. Key words: Pneumonia, mycoplasma; Azithromycin; Glucocorticoid; Children

Efficacy observation on Xiyanping injection treatment for mycoplasma pneumonia in children

Objective To observe the efficacy of Xiyanping injection for the treatment of mycoplasma pneumonia (MPP).Methods 95 cases of MPP treated in our hospital from 2009 to 2011 were randomly divided into 2 groups.The control group of 47 patients was given antibiotics and symptomatic treatment,while the experiment group of 48 patients was added Xiyanping injection.We observed the children with their symptoms and blood mycoplasma antibody titers to evaluate the efficacy of Xiyanping injectionn.Results The experiment group's total effective rate was 93.75％ while control group was 72.34％.The difference was statistically significant (P＜0.05); The temperature recovery time,each symptom relief time,antibody clearance time of the experiment group were significantly lower than those of control group (P＜0.05).Conclusions Xiyanping injection could improve medication effects and at the same time accelerate the disappearance of the signs and symptoms in children. Key words: Xiyanping injection; Mycoplasma pneumonic (MPP); Efficacy

Clinical observation on the montelukast sodium combined with azithromycin treament for mycoplasma pneumonia in children

Objective To investigate the clinical effect of montelukast sodium combined with the azithromycin treatment of mycoplasma pneumonia(MP).Methods 82 cases of MP children were randomly divided into observation group and control group,41 cases in each group,the control group was treated by the azithromycin on the basis of the conventional treatment,the observation group was treated by montelukast sodium on the basis of the treatment for control group,and then compared the children' s body temperature recovery time.cough disappeared time,wheezing disappeared time,and the asthma follow-up occurred within 6 months between the tw0 groups.Results The body temperature recovery time of the observation group and the control group were (3.8 ± 1.1) d and (3.5 ± 1.5) d respectively,the differences were not statistically significant between the two groups (P＞0.05).The coughing and wheezing disappeared time in the observation group and the control groupwere( 21.4 ± 3.4 ) d,(8.1 ± 2.5) d and( 8.1 ± 1.7) d,( 6.0 ± 1.5 ) d,the difFerences were statistically significant between the two groups ( P＜0.05 ).Disease incidence of the mycoplasma pneumomae infection secondary to asthma in the observation group and the control group were 39.02% and 9.76%.the differences were statistically significant between the two groups ( P＜O.01 ).One case of suspected adverse reactions associated with montelukast sodium in the observation group.the incidence of 2.44%.expressed as rash,without spontaneous remission after discontinuation.There were no other significant adverse reactions occurred.Conclusion Montelukast sodium azithromycin treatment for children with MP has better clinical effects,not only can significantly improve the clinical symptoms and signs of the children,but also can reduce the recurrence rate,with fewer complications,which is worthy of clinical application. Key words: Mycoplasma pneumonia; Pediatric; Montelukast sodium; Azithromycin

Factors associated with various clinical manifestations ofMycoplasmapneumonia in children

Purpose: Mycoplasma pneumonia (MP) is a major cause of community-acquired pneumonia in children and young adults. We aimed to investigate the factors that may influence on the clinical manifestations of MP in children. Methods: A total of 109 admitted children from October 2011 to February 2012 were prospectively enrolled with physical examination and laboratory tests (complete blood count, C-reactive protein [CRP], and particle agglutinin assay). The diagnosis of MP was made when there was an infiltration on the chest X-ray and the particle agglutination test was once over 1:640 or showed 4-fold increase in serial tests. They were grouped by age, fever duration after treatment, presence of pleural effusion and wheezing. Results: Preschool children showed shorter duration of fever (P=0.001), more wheezing (P 3 days) and pleural effusion were developed in children with higher CRP (P=0.018 and P=0.007). Wheezing has been developed in children with younger age (P=0.007). Conclusion: Younger age was a risk factor to develop wheezing in MP and prolonged fever and pleural effusion were more likely to develop in children with higher CRP.

Azithromycin combined with clarithromycin for mycoplasma pneumonia in children

Objective To explore the efficacy of combination therapy with azithromycin and clarithromycin for mycoplasma pneumonia in children.Methods 115 children with mycoplasma pneumonia were randomly divided into study group ( 58 children ) and control group ( 57 children ).All the children received supporting therapy and symptomatic treatment.The study group received additional azithromycin combined with clarithromycin for two cycles of treatment while the control group received azithromycin alone.Results Time to disappearance of of fever,cough,and pulmonary signs and time to normalization of lung appearance on X-ray were markedly shorter in the study group than in the control group ( P＜ 0.01 ).The overall effectivenesss rate was significantly higher in the study group than in the control group after 2 cycles of treatment ( 96.6％ vs.84.2％,P ＜ 0.05 ).The incidence rate of adverse reactions was significantly lower in the study group than in the control group ( 5.2％ vs.17.5％,P＜ 0.05 ).Conclusions Azithromycin combined with clarithromycin is rapid,efficacious,and safe in the treatment of mycoplasma pneumonia in children.It is worth popularizing clinically. Key words: Azithromycin; Clarithromycin; Mycoplasma Pneumonia; Children