MYCOPLASMA-PNEUMONIAE AND CHLAMYDIA-PNEUMONIAE IN PEDIATRIC COMMUNITY-ACQUIRED PNEUMONIA - COMPARATIVE EFFICACY AND SAFETY OF CLARITHROMYCIN VS ERYTHROMYCIN ETHYLSUCCINATE
MYCOPLASMA-PNEUMONIAE AND CHLAMYDIA-PNEUMONIAE IN PEDIATRIC COMMUNITY-ACQUIRED PNEUMONIA - COMPARATIVE EFFICACY AND SAFETY OF CLARITHROMYCIN VS ERYTHROMYCIN ETHYLSUCCINATE
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DOI：
10.1097/00006454-199506000-00002
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发表时间：
1995-06-01
影响因子：
3.6
通讯作者：
CRAFT, JC
中科院分区：
文献类型：
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作者：
BLOCK, S;HEDRICK, J;CRAFT, JC
我们评估了260例既往健康的3 - 12岁儿童，他们有肺炎的临床体征和症状，经放射学证实，患者以1：1的比例随机分配至克拉霉素混悬液15 mg/kg/天，每日两次或红霉素混悬液40 mg/kg/天，每日两次或每日三次，疗程10天，28%（74）的患者检测到肺炎衣原体感染的证据：13%（34例）通过鼻咽培养，18%（48例）通过微量免疫荧光试验进行血清学检查，在27%（69例）的患者中检测到肺炎支原体感染的证据：鼻咽培养或聚合酶链反应阳性率为20%（53例），血清学检测阳性率为17%（44例）。pneumoniae和M. pneumoniae，分别克拉霉素与红霉素治疗分别产生了以下结果：临床成功率98%（121/124）与95%（105/110）;放射学成功率98%（109/111）与94%（92/110）;病原体根除，C。肺炎支原体79%（15/19）vs.86%（12/14）;肺炎100%（9/9）vs，100%（4/4）。不良事件主要是胃肠道，两组中几乎有四分之一的患者发生，严重程度为轻度至中度。克拉霉素和红霉素治疗2岁以上经放射学证实的社区获得性肺炎的有效性和安全性相似。pneumoniae或M.在近一半的这些患者中检测到肺炎，大环内酯类可能是3至8岁无毒儿童无并发症肺炎的首选抗生素选择。
We evaluated 260 previously healthy children ages 3 through 12 years who had clinical signs and symptoms of pneumonia, radiographically confirmed, Patients were randomized 1:1 to a 10-day course of either clarithromycin suspension 15 mg/kg/day divided twice a day or erythromycin suspension 40 mg/kg/day divided twice a day or three times a day, Evidence of infection with Chlamydia pneumoniae was detected in 28% (74) of patients: 13% (34) by nasopharyngeal culture and 18% (48) by serology with the microimmunofluorescence assay, Evidence of infection with Mycoplasma pneumoniae was detected in 27% (69) of patients: 20% (53) by nasopharyngeal culture or polymerase chain reaction and 17% (44) by serology with the use of enzyme-linked immunosorbent assay, Serologic confirmation of infection was observed in 23% (8) and 53% (28) of patients with bacteriologically detected C. pneumoniae and M. pneumoniae, respectively. Treatment with clarithromycin vs. erythromycin, respectively, yielded the following outcomes: clinical success 98% (121 of 124) vs, 95% (105 of 110); radiologic success 98% (109 of 111) vs, 94% (92 of 110); and eradication by pathogen, C. pneumoniae 79% (15 of 19) vs, 86% (12 of 14) and M. pneumoniae 100% (9 of 9) vs, 100% (4 of 4). Adverse events were primarily gastrointestinal, occurring in almost one-fourth of patients in both groups, and were mild to moderate in severity, Clarithromycin and erythromycin were similarly effective and safe for the treatment of radiographically proved, community-acquired pneumonia in children older than 2 years old, Because C. pneumoniae or M. pneumoniae was detected in nearly one-half of these patients, macrolides may be the preferred antibiotic choice for uncomplicated pneumonia in nontoxic children ages 3 through 8 years.