Clinical observation of doxycycline in the treatment of macrolide-unresponsive <italic style="font-style: italic">Mycoplasma pneumoniae </italic>pneumonia in children under 8 years of age

LI Shanshan; ZHENG Jishan; CHEN Yanyan; SHEN Longhui

doi:10.6039/j.issn.1001-0408.2025.04.13

您当前的位置：

首页 >

文章列表页 >

Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children under 8 years of age

更新时间：2025-02-21

- Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children under 8 years of age
- ZHONGGUO YAOFANG Vol. 36, Issue 4, Pages: 464-468(2025)
- 作者机构：
  
  1.宁波大学附属妇女儿童医院药剂科，浙江宁波　315012
  2.宁波大学附属妇女儿童医院儿科，浙江宁波　315012
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.04.13
  CLC： R969.3;R978.1
- Received：09 September 2024，
  
  Revised：27 December 2024，
  
  Accepted：2025-01-21，
  
  Published：28 February 2025
- 稿件说明：
移动端阅览
李珊珊,郑吉善,陈燕燕等.多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎的临床观察 ^Δ[J].中国药房,2025,36(04):464-468.

LI Shanshan,ZHENG Jishan,CHEN Yanyan,et al.Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children under 8 years of age[J].ZHONGGUO YAOFANG,2025,36(04):464-468.
李珊珊,郑吉善,陈燕燕等.多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎的临床观察 ^Δ[J].中国药房,2025,36(04):464-468. DOI： 10.6039/j.issn.1001-0408.2025.04.13.

LI Shanshan,ZHENG Jishan,CHEN Yanyan,et al.Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children under 8 years of age[J].ZHONGGUO YAOFANG,2025,36(04):464-468. DOI： 10.6039/j.issn.1001-0408.2025.04.13.

摘要

目的

探讨多西环素治疗8岁以下儿童大环内酯类药物无反应性肺炎支原体肺炎（MUMPP）的疗效与安全性。

方法

回顾性收集2023年1月1日至12月31日宁波大学附属妇女儿童医院收治的8岁以下MUMPP患儿资料，根据不同抗感染治疗方案分为多西环素组（44例）、多西环素联合甲泼尼龙组（35例）、阿奇霉素联合甲泼尼龙组（35例）。多西环素组患儿给予盐酸多西环素肠溶胶囊；多西环素联合甲泼尼龙组患儿给予盐酸多西环素肠溶胶囊+注射用甲泼尼龙琥珀酸钠；阿奇霉素联合甲泼尼龙组患儿给予注射用阿奇霉素+注射用甲泼尼龙琥珀酸钠；3组疗程均为10 d。比较3组患儿的退热率、退热时间、肺部感染吸收好转率，记录其住院期间及出院后5个月内的不良反应发生情况。

结果

多西环素组、多西环素联合甲泼尼龙组患儿治疗后48、72 h的退热率及肺部感染吸收好转率均显著高于阿奇霉素联合甲泼尼龙组，退热时间显著短于阿奇霉素联合甲泼尼龙组（

＜0.05），而多西环素组与多西环素联合甲泼尼龙组比较，差异无统计学意义（

＞0.05）。3组患儿住院期间及出院后5个月内的皮疹、呕吐、腹痛、腹泻及转氨酶升高的发生率比较，差异均无统计学意义（

＞0.05）；使用多西环素的患儿均未出现牙齿发黄、牙釉质发育不良。

结论

多西环素用于8岁以下儿童MUMPP的疗效和安全性均较好；辅助使用低剂量糖皮质激素并不一定能带来明显的额外疗效。

Abstract

OBJECTIVE

To investigate the efficacy and safety of doxycycline in the treatment of macrolide-unresponsive

Mycoplasma pneumoniae

pneumonia （MUMPP） in children under 8 years of age.

METHODS

The medical records of children with MUMPP admitted to the Women and Children’s Hospital Affiliated to Ningbo University were collected from January 1st， 2023 to December 31st， 2023. They were divided into doxycycline group （44 cases）， doxycycline combined with methylprednisolone group （35 cases）， and azithromycin combined with methylprednisolone group （35 cases） according to the treatment methods. Doxycycline group was given Doxycycline hyclate enteric-coated capsules； doxycycline combined with methylprednisolone group was given Doxycycline hyclate enteric-coated capsules and Methylprednisolone sodium succinate for injection； azithromycin combined with methylprednisolone group was given Azithromycin for injection and Methylprednisolone sodium succinate for injection. Treatment courses of 3 groups lasted for 10 d. The fever reduction rate， the time of fever reduction and improvement rate of lung infection absorption were compared among the three groups. The occurrence of adverse drug reactions was recorded during their hospitalization and followed up within 5 months after discharge.

RESULTS

The fever reduction rats 48， 72 h after treatment and improvement rate of lung infection absorption in doxycycline group and doxycycline combined with methylprednisolone group were significantly higher than azithromycin combined with methylprednisolone group； the time of fever reduction was significantly shorter than azithromycin combined with methylprednisolone group （

＜0.05）； there was no statistical significance in the difference between the doxycycline group and the doxycycline combined with methylprednisolone group （

＞0.05）. There was no statistical significance in the incidence

of rash， vomiting， abdominal pain， diarrhea， and elevated transaminases among the three groups during hospitalization and within 5 months after discharge （

＞0.05）. None of the children treated with doxycycline suffered from tooth discoloration or enamel hypoplasia.

CONCLUSIONS

Doxycycline has good efficacy and safety in therapy of MUMPP in children under 8 years of age； adjunctive coadministration of low-dose glucocorticoids does not necessarily result in significant additional efficacy.

关键词

Keywords

references

国家卫生健康委员会 . 儿童肺炎支原体肺炎诊疗指南：2023年版 [J ] . 中国合理用药探索， 2023 ， 20 （ 3 ）： 16 - 24 .

National Health Commission . Guidelines for diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children：2023 edition [J ] . Chin Rational Drug Use ， 2023 ， 20 （ 3 ）： 16 - 24 .

KIM K ， JUNG S ， KIM M ， et al . Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections：a systematic review and meta-analysis [J ] . JAMA Netw Open ， 2022 ， 5 （ 7 ）： e2220949 .

ZHOU Y L ， ZHANG Y Y ， SHENG Y J ， et al . More complications occur in macrolide-resistant than in macrolide-sensitive Mycoplasma pneumoniae pneumonia [J ] . Antimicrob Agents Chemother ， 2014 ， 58 （ 2 ）： 1034 - 1038 .

涂鹏，窦海伟，史大伟，等 . 流感样病例中肺炎支原体感染与耐药情况研究 [J ] . 中国全科医学， 2022 ， 25 （ 2 ）： 145 - 148，158 .

TU P ， DOU H W ， SHI D W ， et al . Infection and drug resistance of Mycoplasma pneumoniae ：an analysis of influenza-like illness [J ] . Chin Gen Pract ， 2022 ， 25 （ 2 ）： 145 - 148，158 .

王亚翠，吴喜蓉，刘芳，等 . 2016年至2019年北京住院儿童肺炎支原体感染流行病学特征和耐药性 [J ] . 中华实用儿科临床杂志， 2022 ， 37 （ 14 ）： 1082 - 1085 .

WANG Y C ， WU X R ， LIU F ， et al . Epidemiological characteristics and macrolide-resistance of children hospitalized with Mycoplasma pneumoniae infection in Beijing from 2016 to 2019 [J ] . Chin J Appl Clin Pediatr ， 2022 ， 37 （ 14 ）： 1082 - 1085 .

YANG H J ， SONG D J ， SHIM J Y . Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children [J ] . Korean J Pediatr ， 2017 ， 60 （ 6 ）： 167 - 174 .

PEREYRE S ， GORET J ， BÉBÉAR C . Mycoplasma pneumoniae ：current knowledge on macrolide resistance and treatment [J ] . Front Microbiol ， 2016 ， 7 ： 974 .

临床常用四环素类药物合理应用多学科专家共识编写组，中华预防医学会医院感染控制分会，中国药理学会临床药理分会 . 临床常用四环素类药物合理应用多学科专家共识 [J ] . 中华医学杂志， 2023 ， 103 （ 30 ）： 2281 - 2296 .

Editing Group for Multidisciplinary Expert Consensus on the Rational Use of Tetracyclines Commonly Used in Clinical Practice ， Hospital Infection Control Branch of Chinese Preventive Medicine Association ， Clinical Pharmacology Branch of Chinese Pharmacological Society . Multidisciplinary expert consensus on the rational use of tetracyclines commonly used in clinical practice [J ] . Natl Med J China ， 2023 ， 103 （ 30 ）： 2281 - 2296 .

SUN L L ， YE C ， ZHOU Y L ， et al . Meta-analysis of the clinical efficacy and safety of high- and low-dose methylprednisolone in the treatment of children with severe Mycoplasma pneumoniae pneumonia [J ] . Pediatr Infect Dis J ， 2020 ， 39 （ 3 ）： 177 - 183 .

BAE E ， KIM Y J ， KANG H M ， et al . Macrolide versus non-macrolide in combination with steroids for the treatment of lobar or segmental Mycoplasma pneumoniae pneumonia unresponsive to initial macrolide monotherapy [J ] . Antibiotics ， 2022 ， 11 （ 9 ）： 1233 .

NARANJO C A ， BUSTO U ， SELLERS E M ， et al . A method for estimating the probability of adverse drug reactions [J ] . Clin Pharmacol Ther ， 1981 ， 30 （ 2 ）： 239 - 245 .

FREITES-MARTINEZ A ， SANTANA N ， ARIAS-SANTIAGO S ， et al . Using the common terminology criteria for adverse events（CTCAE - version 5.0）to evaluate the severity of adverse events of anticancer therapies [J ] . Actas Dermosifiliogr ， 2021 ， 112 （ 1 ）： 90 - 92 .

LEE H ， YUN K W ， LEE H J ， et al . Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneu-monia in children [J ] . Expert Rev Anti Infect Ther ， 2018 ， 16 （ 1 ）： 23 - 34 .

GORDON O ， OSTER Y ， MICHAEL-GAYEGO A ， et al . The clinical presentation of pediatric Mycoplasma pneumoniae infections：a single center cohort [J ] . Pediatr Infect Dis J ， 2019 ， 38 （ 7 ）： 698 - 705 .

KAWAI Y ， MIYASHITA N ， KUBO M ， et al . Therapeutic efficacy of macrolides，minocycline，and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients [J ] . Antimicrob Agents Chemother ， 2013 ， 57 （ 5 ）： 2252 - 2258 .

CHEONG K N ， CHIU S S ， CHAN B W ， et al . Severe macrolide-resistant Mycoplasma pneumoniae pneumonia ass ociated with macrolide failure [J ] . Wei Mian Yu Gan Ran Za Zhi ， 2016 ， 49 （ 1 ）： 127 - 130 .

CHEN Y ， ZHANG Y ， TANG Q N ， et al . Efficacy of doxycycline therapy for macrolide-resistant Mycoplasma pneumoniae pneumonia in children at different periods [J ] . Ital J Pediatr ， 2024 ， 50 （ 1 ）： 38 .

LEE H ， CHOI Y Y ， SOHN Y J ， et al . Clinical efficacy of doxycycline for treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children [J ] . Antibiotics ， 2021 ， 10 （ 2 ）： 192 .

OKADA T ， MOROZUMI M ， TAJIMA T ， et al . Rapid effectiveness of minocycline or doxycycline against macrolide-resistant Mycoplasma pneumoniae infection in a 2011 outbreak among Japanese children [J ] . Clin Infect Dis ， 2012 ， 55 （ 12 ）： 1642 - 1649 .

殷勇，陈健德 . 儿童大环内酯类耐药肺炎支原体肺炎诊疗理念与实践 [J ] . 临床儿科杂志， 2024 ， 42 （ 3 ）： 177 - 181 .

YIN Y ， CHEN J D . Diagnosis and treatment philosophy and practice of macrolide-resistant Mycoplasma pneumoniae pneumonia in children [J ] . J Clin Pediatr ， 2024 ， 42 （ 3 ）： 177 - 181 .

GAVRILOVIC S ， ANDRIJEVIC A ， MUJAKOVIC A ， et al . Adjunct corticosteroid treatment in patients with pneumonia：a precision medicine approach [J ] . Bosn J Basic Med Sci ， 2019 ， 19 （ 4 ）： 315 - 320 .

王克华，郭琼杰，王娜 . 基于美国FDA不良事件报告系统数据库的多西环素儿童相关不良事件风险信号挖掘 [J ] . 药物不良反应杂志， 2024 ， 26 （ 3 ）： 157 - 161 .

WANG K H ， GUO Q J ， WANG N . Signal mining of risk of doxycycline-related adverse events in children based on US FDA adverse event reporting system database [J ] . Adverse Drug React J ， 2024 ， 26 （ 3 ）： 157 - 161 .

陈龙，陈高艳，丁楠楠 . 基于FAERS数据库对8岁以下儿童使用四环素类药物的ADR信号挖掘 [J ] . 中南药学， 2024 ， 22 （ 10 ）： 2819 - 2825 .

CHEN L ， CHEN G Y ， DING N N . Data mining of tetracyclines ADR signals in children under 8 based on FAERS database [J ] . Cent South Pharm ， 2024 ， 22 （ 10 ）： 2819 - 2825 .

DAĞ M S ， ÖZTÜRK Z A ， AKıN I ， et al . Drug-induced esophageal ulcers：case series and the review of the literature [J ] . Turk J Gastroenterol ， 2014 ， 25 （ 2 ）： 180 - 184 .

王璐，曾露，魏安华 . 基于美国FDA不良事件报告系统数据库的不同年龄段人群多西环素风险信号分析 [J ] . 中国临床药学杂志， 2024 ， 33 （ 7 ）： 509 - 514 .

WANG L ， ZENG L ， WEI A H . Analysis of risk signals of doxycycline in different age groups based on the FDA adverse event reporting system database [J ] . Chin J Clin Pharm ， 2024 ， 33 （ 7 ）： 509 - 514 .

BLAKELY K M ， DRUCKER A M ， ROSEN C F . Drug-induced photosensitivity：an update：culprit drugs，prevention and management [J ] . Drug Saf ， 2019 ， 42 （ 7 ）： 827 - 847 .

LAYTON A M ， CUNLIFFE W J . Phototoxic eruptions due to doxycycline：a dose-related phenomenon [J ] . Clin Exp Dermatol ， 1993 ， 18 （ 5 ）： 425 - 427 .

RAVINDRA D ， HUANG G ， HALLETT K ， et al . Antibiotic exposure and dental health：a systematic review [J ] . Pediatrics ， 2023 ， 152 （ 1 ）： e2023061350 .

WEI C Y ， LIU Y ， JIANG A D ， et al . A pharmacovigilance study of the association between tetracyclines and hepatotoxicity based on Food and Drug Administration adverse event reporting system data [J ] . Int J Clin Pharm ， 2022 ， 44 （ 3 ）： 709 - 716 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Meta-analysis of the efficacy and safety of PD-1/PD-L1 inhibitors combined with bevacizumab in the treatment of advanced non-small cell lung cancer

Clinical observation of vonoprazan-based triple therapy in treatment-naive patients with Helicobacter pylori infection

Comparison of the efficacy and safety between the drug winning the bidding for centralized procurement and the original drug of ticagrelor in acute coronary syndrome patients after percutaneous coronary intervention

Clinical observation of venetoclax combined with homoharringtonine and cytarabine in the treatment of acute myeloid leukemia

Clinical observation of camrelizumab combined with sorafenib in the treatment of advanced liver cancer

Related Author

LUO Hongmei

ZOU Jiafeng

ZHAO Jiufeng

SUN Chengxin

YANG Jianwen

HAN Shaowei

DENG Zijie

LYU Tao

Related Institution

Dept. of Pharmacy， the Affiliated Hospital of Zunyi Medical University

School of Pharmacy， Zunyi Medical University

Dept. of Pharmacy， the University of Hong Kong-Shenzhen Hospital

Dept. of Gastroenterology， the University of Hong Kong-Shenzhen Hospital

Dept. of Pharmacy， Yancheng First Hospital Affiliated of Nanjing University Medical School/Yancheng No. 1 People’s Hospital

Address：8th Floor, Sihuan Building, No. 129 Daping Main Street, Yuzhong District, Chongqing, China Postal code：400042
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰

Clinical observation of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children under 8 years of age

DOI：10.6039/j.issn.1001-0408.2025.04.13

摘要

Abstract

关键词

Keywords

references