Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae
Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae
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DOI：
10.1128/aac.50.2.709-712.2006
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发表时间：
2006-02-01
影响因子：
4.9
通讯作者：
Sasaki, T
中科院分区：
文献类型：
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作者：
Suzuki, S;Yamazaki, T;Sasaki, T
自2000年以来，日本已从临床标本中分离出耐大环内酯肺炎支原体（MR . pneumoniae）。进行了一项比较研究，以确定大环内酯类药物是否有效治疗感染肺炎支原体的患者。比较大环内酯类药物治疗的11例MR肺炎支原体感染（MR患者）与26例大环内酯类药物敏感肺炎支原体感染（MS患者）的临床病程。MR患者在大环内酯给药期间的总发热天数和发热天数均长于MS患者（中位数为8天，中位数为5天[P = 0.019]；中位数为3天，中位数为1天[P = 0.002]）。此外，MR患者比MS患者更有可能将最初处方的大环内酯改为另一种抗菌药物（63.6%对3.8%；优势比为43.8;P < 0.001），这可能反映了儿科医生对这些患者最初处方的大环内酯不够有效的判断。尽管给予大环内酯类药物的MR患者发热期延长，但即使不改变初始处方，发热也会消失。这些结果表明大环内酯类药物对MR患者的疗效肯定较差。
Macrolide-resistant Mycoplasma pneumoniae (MR M. pneumoniae) has been isolated from clinical specimens in Japan since 2000. A comparative study was carried out to determine whether or not macrolides are effective in treating patients infected with MR M. pneumoniae. The clinical courses of 11 patients with MR M. pneumoniae infection (MR patients) treated with macrolides were compared with those of 26 patients with macrolide-susceptible M. pneumoniae infection (MS patients). The total febrile days and the number of febrile days during macrolide administration were longer in the MR patients than in the MS patients (median of 8 days versus median of 5 days [P = 0.019] and 3 days versus I day [P = 0.002], respectively). In addition, the MR patients were more likely than the MS patients to have had a change of the initially prescribed macrolide to another antimicrobial agent (63.6% versus 3.8%; odds ratio, 43.8; P < 0.001), which might reflect the pediatrician's judgment that the initially prescribed macrolide was not sufficiently effective in these patients. Despite the fact that the febrile period was prolonged in MR patients given macrolides, the fever resolved even when the initial prescription was not changed. These results show that macrolides are certainly less effective in MR patients.