본문 바로가기
KERD
논문KCI 등재

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

주제분류소아과학

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)

  1. 유진호, "마크로라이드 내성 마이코플라즈마 폐렴이 우리에게 안긴 숙제는?", Allergy Asthma & Respiratory Disease, 5(1), pp.1~2 (2017), 대한 소아알레르기 호흡기학회[DOI]
  2. 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
  3. 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
  4. 김지현, "최근 6년간(1998-2003) 소아 Mycoplasma 폐렴의 임상 양상", Clinical and Experimental Pediatrics, 48(9), pp.959~975 (2005), 대한소아청소년과학회
  5. Eun BW, "Mycoplasma pneumoniae in Korean children: the epidemiology of pneumonia over an 18-year period", J Infect, 56, pp.326~331 (2008)[DOI]
  6. He J, "Insights into the pathogenesis of Mycoplasma pneumoniae (Review)", Mol Med Rep, 14, pp.4030~4036 (2016)[DOI]
  7. 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)
  8. Prince OA, "In vitro spatial and temporal analysis of Mycoplasma pneumoniae colonization of human airway epithelium", Infect Immun, 82, pp.579~586 (2014)[DOI]
  9. Grosshennig S, "Implication of glycerol and phospholipid transporters in Mycoplasma pneumoniae growth and virulence", Infect Immun, 81, pp.896~904 (2013)[DOI]
  10. 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]
  11. 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]
  12. Hong KB, "Macrolide resistance of Mycoplasma pneumoniae, South Korea, 2000-2011", Emerg Infect Dis, 19, pp.1281~1284 (2013)[DOI]
  13. Xin D, "Molecular mechanisms of macrolide resistance in clinical isolates of Mycoplasma pneumoniae from China", Antimicrob Agents Chemother, 53, pp.2158~2159 (2009)[DOI]
  14. Morozumi M, "Increased macrolide resistance of Mycoplasma pneumoniae in pediatric patients with community-acquired pneumonia", Antimicrob Agents Chemother, 52, pp.348~350 (2008)[DOI]
  15. 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
  16. Jackson MA, "The use of systemic and topical fluoroquinolones", Pediatrics, 138(5) (2016)
  17. You-Sook Youn, "Mycoplasma pneumoniae pneumonia in children", Clinical and Experimental Pediatrics, 55(2), pp.42~47 (2012), 대한소아청소년과학회
  18. Busson L, "Evaluation of 10 serological assays for diagnosing Mycoplasma pneumoniae infection", Diagn Microbiol Infect Dis, 76, pp.133~137 (2013)[DOI]
  19. 유선영, "Effects of Methylprednisolone Pulse Therapy on Refractory Mycoplasma pneumoniae Pneumonia in Children", Allergy, Asthma & Immunology Research, 6(1), pp.22~26 (2014), 대한천식알레르기학회
  20. 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
  21. 오재원, "The Efficacy of Glucocorticoid on Macrolide Resistant Mycoplasma Pneumonia in Children", Allergy, Asthma & Immunology Research, 6(1), pp.3~5 (2014), 대한천식알레르기학회
  22. Lee KY, "Role of prednisolone treatment in severe Mycoplasma pneumoniae pneumonia in children", Pediatr Pulmonol, 41, pp.263~268 (2006)[DOI]
  23. Luo Z, "Effects of prednisolone on refractory mycoplasma pneumoniae pneumonia in children", Pediatr Pulmonol, 49, pp.377~380 (2014)[DOI]
  24. 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
  25. Gardiner SJ, "Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children", Cochrane Database Syst Rev, 1 (2015)

관련 논문AI추천

입원한 소아의 마이코플라스마 폐렴에서 치료 행태 분석: 다기관 후향적 연구심정연, 안영민, 이영주, 장광천, 정은희, 정혜리, 황윤하대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2020 · 제8권 제2호마이코플라스마 폐렴에서 조기 스테로이드 사용의 유용성김령, 김경심, 김용욱, 김은영, 김희성, 송명곤, 장해인, 조형민대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2017 · 제5권 제5호증가하는 마크로라이드에 반응하지 않는 마이코플라스마 폐렴의 관련 인자와 임상 양상의 변화김효빈, 박진성, 유인경, 정지현, 탕지륭대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2018 · 제6권 제2호Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children: An Observation Study강진한, 신명석, 윤유숙, 이성철, Jung-Woo Rhim, Kyung-Yil Lee대한감염학회 · Infection and Chemotherapy2014 · 제46권 제4호최근 3번의 대유행 동안 한국 소아에서 발생한마이코플라즈마 폐렴의 임상적 특징김덕수, 민동훈, 박문수, 심재원, 심정연, 위화현, 정혜림대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2017 · 제5권 제1호자매에서 발생한 중증 마이코플라즈마 폐렴에서 스테로이드 치료강진한, 김도희, 김명숙, 윤유숙, 이경일, 이준성, 임정우, 황자영대한감염학회 · Infection and Chemotherapy2009 · 제41권 제3호

이 간행물의 다른 논문 (10건)