Mycoplasma pneumoniae infections - Does treatment help?
Mycoplasma pneumoniae infections - Does treatment help?
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DOI：
10.1016/j.jinf.2014.07.017
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发表时间：
2014-11-01
影响因子：
28.2
通讯作者：
van Rossum, Annemarie M. C.
中科院分区：
文献类型：
--
作者：
Spuesens, Emiel B. M.;Sauteur, Patrick M. Meyer;van Rossum, Annemarie M. C.
肺炎支原体是呼吸道感染(RTI)的常见原因，尤其是在儿童中。虽然重症肺炎支原体感染通常使用抗生素治疗，但应根据最近的临床结果重新考虑这些感染的诊断和治疗。首先，在健康的、无症状的儿童中，发现上呼吸道携带肺炎支原体的比例相对较高。显然，这使疑似肺炎支原体呼吸道感染的诊断复杂化，从而使何时开始治疗的决定复杂化。治疗这些感染的一个并发症是，关于肺炎支原体RTI的抗生素治疗效果的数据很少，而且完全来自比较研究。Cochrane最近的一篇综述得出的结论是，没有足够的证据表明抗生素对儿童肺炎支原体下呼吸道感染(LRTI)的疗效。由于儿童使用四环素和喹诺酮类药物的副作用，只有大环内酯类药物可以用于治疗年轻患者的肺炎支原体感染。然而，大环内酯类抗生素的普遍适用性目前正受到全球耐大环内酯类肺炎支原体菌株增加的威胁。最后，有限的证据表明，皮质类固醇在治疗肺炎支原体感染方面可能有额外的好处。在这篇综述中，将讨论目前与肺炎支原体感染的诊断和治疗有关的问题。(C)2014年英国感染协会。爱思唯尔有限公司出版。保留所有权利。
Mycoplasma pneumoniae is a common cause of respiratory tract infections (RTI's), especially in children. While severe M. pneumoniae infections are generally treated with antibiotics, the diagnosis as well as treatment of these infections should be reconsidered in the light of recent clinical findings. First, M. pneumoniae was found to be carried in the upper respiratory tract of a relatively high percentage of healthy, asymptomatic children. Clearly, this complicates the diagnosis of a suspected M. pneumoniae RTI and, thus, the decision when to initiate treatment. A complication in the treatment of these infections is that data on the efficacy of antibiotic treatment of M. pneumoniae RTI's are sparse and derived exclusively from comparative studies. A recent Cochrane review concluded that there is insufficient evidence about the efficacy of antibiotics for M. pneumoniae lower respiratory tract infections (LRTI) in children. Due to side effects associated with the use of tetracyclines and quinolones in children, only macrolides can be used to treat M. pneumoniae infections in young patients. The general applicability of macrolides, however, is currently threatened by the worldwide increase in macrolide-resistant M. pneumoniae strains. Finally, limited evidence is available that corticosteroids might have an additional benefit in the treatment of M. pneumoniae infections. In this review, the current issues related to the diagnosis and treatment of M. pneumoniae infections will be discussed. (C) 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.