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Efficacy of tetracyclines and fluoroquinolones for the treatment of macrolide-refractory Mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis
DC Field | Value | Language |
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dc.contributor.author | 안종균 | - |
dc.date.accessioned | 2021-12-28T16:41:26Z | - |
dc.date.available | 2021-12-28T16:41:26Z | - |
dc.date.issued | 2021-12 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/186753 | - |
dc.description.abstract | Background: Mycoplasma pneumoniae is a common pathogen that causes community-acquired pneumonia in school-age children. Macrolides are considered a first-line treatment for M. pneumoniae infection in children, but macrolide-refractory M. pneumoniae (MRMP) strains have become more common. In this study, we assessed the efficacy of tetracyclines and fluoroquinolones in MRMP treatment in children through a systematic review and meta-analysis. Methods: Two reviewers individually searched 10 electronic databases (Medline/Pubmed, Embase, the Cochrane Library, and core Korean, Chinese, and Japanese journals) for papers published from January 1, 1990 to March 8, 2018. The following data for each treatment group were extracted from the selected studies: intervention (tetracyclines and fluoroquinolones/comparator), patient characteristics (age and sex), and outcomes (fever duration, hospital stay length, treatment success rate, and defervescence rates 24, 48, and 72 h after starting treatment). Results: Eight studies involving 537 participants were included. Fever duration and hospital stay length were shorter in the tetracycline group than in the macrolide group (weighted mean difference [WMD] = - 1.45, 95% confidence interval [CI]: - 2.55 to - 0.36, P = 0.009; and WMD = - 3.33, 95% CI: - 4.32 to - 2.35, P < 0.00001, respectively). The therapeutic efficacy was significantly higher in the tetracycline group than in the macrolide group (odds ratio [OR]: 8.80, 95% CI: 3.12-24.82). With regard to defervescence rate, patients in the tetracycline group showed significant improvement compared to those in the macrolide group (defervescence rate after 24 h, OR: 5.34, 95% CI: 1.81-15.75; after 48 h, OR 18.37, 95% CI: 8.87-38.03; and after 72 h, OR: 40.77, 95% CI: 6.15-270.12). There were no differences in fever improvement within 24 h in patients in the fluoroquinolone group compared to those in the macrolide group (OR: 1.11, 95% CI: 0.25-5.00), although the defervescence rate was higher after 48 h in the fluoroquinolone group (OR: 2.78, 95% CI: 1.41-5.51). Conclusion: Tetracyclines may shorten fever duration and hospital stay length in patients with MRMP infection. Fluoroquinolones may achieve defervescence within 48 h in patients with MRMP infection. However, these results should be carefully interpreted as only a small number of studies were included, and they were heterogeneous. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | BioMed Central | - |
dc.relation.isPartOf | BMC INFECTIOUS DISEASES | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Anti-Bacterial Agents / pharmacology | - |
dc.subject.MESH | Anti-Bacterial Agents / therapeutic use | - |
dc.subject.MESH | Child | - |
dc.subject.MESH | Drug Resistance, Bacterial | - |
dc.subject.MESH | Fluoroquinolones / pharmacology | - |
dc.subject.MESH | Fluoroquinolones / therapeutic use | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Macrolides / pharmacology | - |
dc.subject.MESH | Macrolides / therapeutic use | - |
dc.subject.MESH | Mycoplasma pneumoniae* | - |
dc.subject.MESH | Pneumonia, Mycoplasma* / drug therapy | - |
dc.subject.MESH | Tetracyclines / pharmacology | - |
dc.subject.MESH | Tetracyclines / therapeutic use | - |
dc.title | Efficacy of tetracyclines and fluoroquinolones for the treatment of macrolide-refractory Mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Pediatrics (소아과학교실) | - |
dc.contributor.googleauthor | Jong Gyun Ahn | - |
dc.contributor.googleauthor | Hye-Kyung Cho | - |
dc.contributor.googleauthor | Donghe Li | - |
dc.contributor.googleauthor | Miyoung Choi | - |
dc.contributor.googleauthor | Jina Lee | - |
dc.contributor.googleauthor | Byung-Wook Eun | - |
dc.contributor.googleauthor | Dae Sun Jo | - |
dc.contributor.googleauthor | Su Eun Park | - |
dc.contributor.googleauthor | Eun Hwa Choi | - |
dc.contributor.googleauthor | Hyeon-Jong Yang | - |
dc.contributor.googleauthor | Ki Hwan Kim | - |
dc.identifier.doi | 10.1186/s12879-021-06508-7 | - |
dc.contributor.localId | A02261 | - |
dc.relation.journalcode | J00360 | - |
dc.identifier.eissn | 1471-2334 | - |
dc.identifier.pmid | 34563128 | - |
dc.subject.keyword | Child | - |
dc.subject.keyword | Fluoroquinolone | - |
dc.subject.keyword | Macrolide-resistant | - |
dc.subject.keyword | Mycoplasma pneumoniae | - |
dc.subject.keyword | Tetracycline | - |
dc.contributor.alternativeName | Ahn, Jong Gyun | - |
dc.contributor.affiliatedAuthor | 안종균 | - |
dc.citation.volume | 21 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 1003 | - |
dc.identifier.bibliographicCitation | BMC INFECTIOUS DISEASES, Vol.21(1) : 1003, 2021-12 | - |
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