단일 2차 기관에서 소아 마이코플라스마 폐렴 환자의 치료를 위한 스테로이드 사용 현황과 효과
Current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Steroids can be used as an adjuvant therapy in the management of mycoplasma pneumonia, but no definite guidelines for the use of steroids have been established. The purpose of this study was to analyze the current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital in Korea. Methods: We retrospectively reviewed the medical records of 152 patients who were admitted due to mycoplasma pneumonia. The patients were divided into 3 groups as follows: those who did not use steroids (81 patients, 53%), those who used steroids after their fever subsided (42 patients, 28%) and those who used steroids during fever (29 patients, 19%). Results: In decreasing order of values, the duration of fever during hospitalization (60.0±40.2 hours vs. 37.3±28.5 hours vs. 29.7±29.5 hours, P=0.006) and duration of hospitalization (5.9±1.7 days vs. 5.0±1.4 days vs. 4.0±1.5 days, P<0.001) were reported in the group which received steroids during fever, the group which received steroids after the fever subsided and the group which did not receive steroids. In the group which received steroids during fever, patients with early steroid use (within 24 hours) had a shorter fever duration in the hospital (12.0 hours vs. 73.5 hours, P<0.001) and a hospitalization duration (5.0 days vs. 6.5 days, P=0.007) than those with late steroid use (after 24 hours). Conclusion: Steroids were used in 47% of patients with mycoplasma pneumonia. The patients who received early steroids had a shorter fever duration and a shorter hospital stay than those who received late steroids.
Abstract
Purpose: Steroids can be used as an adjuvant therapy in the management of mycoplasma pneumonia, but no definite guidelines for the use of steroids have been established. The purpose of this study was to analyze the current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital in Korea. Methods: We retrospectively reviewed the medical records of 152 patients who were admitted due to mycoplasma pneumonia. The patients were divided into 3 groups as follows: those who did not use steroids (81 patients, 53%), those who used steroids after their fever subsided (42 patients, 28%) and those who used steroids during fever (29 patients, 19%). Results: In decreasing order of values, the duration of fever during hospitalization (60.0±40.2 hours vs. 37.3±28.5 hours vs. 29.7±29.5 hours, P=0.006) and duration of hospitalization (5.9±1.7 days vs. 5.0±1.4 days vs. 4.0±1.5 days, P<0.001) were reported in the group which received steroids during fever, the group which received steroids after the fever subsided and the group which did not receive steroids. In the group which received steroids during fever, patients with early steroid use (within 24 hours) had a shorter fever duration in the hospital (12.0 hours vs. 73.5 hours, P<0.001) and a hospitalization duration (5.0 days vs. 6.5 days, P=0.007) than those with late steroid use (after 24 hours). Conclusion: Steroids were used in 47% of patients with mycoplasma pneumonia. The patients who received early steroids had a shorter fever duration and a shorter hospital stay than those who received late steroids.
참고문헌 (25)
- 유진호, "마크로라이드 내성 마이코플라즈마 폐렴이 우리에게 안긴 숙제는?", Allergy Asthma & Respiratory Disease, 5(1), pp.1~2 (2017), 대한 소아알레르기 호흡기학회[DOI]
- 김종현, "Macrolide Resistance and Its Impacts on M. Pneumoniae Pneumonia in Children: Comparison of Two Recent Epidemics in Korea", Allergy, Asthma & Immunology Research, 9(4), pp.340~346 (2017), 대한천식알레르기학회
- 김은경, "Epidemiological comparison of three Mycoplasma pneumoniae pneumonia epidemics in a single hospital over 10 years", Clinical and Experimental Pediatrics, 58(5), pp.172~177 (2015), 대한소아청소년과학회
- 김지현, "최근 6년간(1998-2003) 소아 Mycoplasma 폐렴의 임상 양상", Clinical and Experimental Pediatrics, 48(9), pp.959~975 (2005), 대한소아청소년과학회
- Eun BW, "Mycoplasma pneumoniae in Korean children: the epidemiology of pneumonia over an 18-year period", J Infect, 56, pp.326~331 (2008)[DOI]
- He J, "Insights into the pathogenesis of Mycoplasma pneumoniae (Review)", Mol Med Rep, 14, pp.4030~4036 (2016)[DOI]
- Balish MF, "Localization of Mycoplasma pneumoniae cytadherence-associated protein HMW2 by fusion with green fluorescent protein: implications for attachment organelle structure", Mol Microbiol, 47, pp.49~60 (2003)
- Prince OA, "In vitro spatial and temporal analysis of Mycoplasma pneumoniae colonization of human airway epithelium", Infect Immun, 82, pp.579~586 (2014)[DOI]
- Grosshennig S, "Implication of glycerol and phospholipid transporters in Mycoplasma pneumoniae growth and virulence", Infect Immun, 81, pp.896~904 (2013)[DOI]
- Hardy RD, "Analysis of pulmonary inflammation and function in the mouse and baboon after exposure to Mycoplasma pneumoniae CARDS toxin", PLoS One, 4, pp.e7562~ (2009)[DOI]
- Lynch M, "Mycoplasmas in Australian fur seals (Arctocephalus pusillus doriferus): identification and association with abortion", J Vet Diagn Invest, 23, pp.1123~1130 (2011)[DOI]
- Hong KB, "Macrolide resistance of Mycoplasma pneumoniae, South Korea, 2000-2011", Emerg Infect Dis, 19, pp.1281~1284 (2013)[DOI]
- Xin D, "Molecular mechanisms of macrolide resistance in clinical isolates of Mycoplasma pneumoniae from China", Antimicrob Agents Chemother, 53, pp.2158~2159 (2009)[DOI]
- Morozumi M, "Increased macrolide resistance of Mycoplasma pneumoniae in pediatric patients with community-acquired pneumonia", Antimicrob Agents Chemother, 52, pp.348~350 (2008)[DOI]
- 이은, "Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children", Clinical and Experimental Pediatrics, 60(5), pp.151~157 (2017), 대한소아청소년과학회
- Jackson MA, "The use of systemic and topical fluoroquinolones", Pediatrics, 138(5) (2016)
- You-Sook Youn, "Mycoplasma pneumoniae pneumonia in children", Clinical and Experimental Pediatrics, 55(2), pp.42~47 (2012), 대한소아청소년과학회
- Busson L, "Evaluation of 10 serological assays for diagnosing Mycoplasma pneumoniae infection", Diagn Microbiol Infect Dis, 76, pp.133~137 (2013)[DOI]
- 유선영, "Effects of Methylprednisolone Pulse Therapy on Refractory Mycoplasma pneumoniae Pneumonia in Children", Allergy, Asthma & Immunology Research, 6(1), pp.22~26 (2014), 대한천식알레르기학회
- 신정은, "Increased risk of refractory Mycoplasma pneumoniae pneumonia in children with atopic sensitization and asthma", Clinical and Experimental Pediatrics, 57(6), pp.271~277 (2014), 대한소아청소년과학회
- 오재원, "The Efficacy of Glucocorticoid on Macrolide Resistant Mycoplasma Pneumonia in Children", Allergy, Asthma & Immunology Research, 6(1), pp.3~5 (2014), 대한천식알레르기학회
- Lee KY, "Role of prednisolone treatment in severe Mycoplasma pneumoniae pneumonia in children", Pediatr Pulmonol, 41, pp.263~268 (2006)[DOI]
- Luo Z, "Effects of prednisolone on refractory mycoplasma pneumoniae pneumonia in children", Pediatr Pulmonol, 49, pp.377~380 (2014)[DOI]
- 서영호, "Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia", Clinical and Experimental Pediatrics, 57(4), pp.186~191 (2014), 대한소아청소년과학회
- Gardiner SJ, "Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children", Cochrane Database Syst Rev, 1 (2015)
