Increased risk of refractory pneumonia in children with atopic sensitization and asthma
PurposeA nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory c...
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doaj-427997d6c706461a892eb6d25ce668b52020-11-24T21:33:27ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582014-06-0157627127710.3345/kjp.2014.57.6.2712014600002Increased risk of refractory pneumonia in children with atopic sensitization and asthmaJeong Eun Shin0Bo Ram Cheon1Jae Won Shim2Deok Soo Kim3Hae Lim Jung4Moon Soo Park5Jung Yeon Shim6Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.PurposeA nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP.MethodsWe investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over 38.3℃ with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases.ResultsThere were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender.ConclusionChildren with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children.http://kjp.or.kr/upload/pdf/kjped-57-271.pdfAsthmaAtopyChildPneumoniaMycoplasma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeong Eun Shin Bo Ram Cheon Jae Won Shim Deok Soo Kim Hae Lim Jung Moon Soo Park Jung Yeon Shim |
spellingShingle |
Jeong Eun Shin Bo Ram Cheon Jae Won Shim Deok Soo Kim Hae Lim Jung Moon Soo Park Jung Yeon Shim Increased risk of refractory pneumonia in children with atopic sensitization and asthma Korean Journal of Pediatrics Asthma Atopy Child Pneumonia Mycoplasma |
author_facet |
Jeong Eun Shin Bo Ram Cheon Jae Won Shim Deok Soo Kim Hae Lim Jung Moon Soo Park Jung Yeon Shim |
author_sort |
Jeong Eun Shin |
title |
Increased risk of refractory pneumonia in children with atopic sensitization and asthma |
title_short |
Increased risk of refractory pneumonia in children with atopic sensitization and asthma |
title_full |
Increased risk of refractory pneumonia in children with atopic sensitization and asthma |
title_fullStr |
Increased risk of refractory pneumonia in children with atopic sensitization and asthma |
title_full_unstemmed |
Increased risk of refractory pneumonia in children with atopic sensitization and asthma |
title_sort |
increased risk of refractory pneumonia in children with atopic sensitization and asthma |
publisher |
Korean Pediatric Society |
series |
Korean Journal of Pediatrics |
issn |
1738-1061 2092-7258 |
publishDate |
2014-06-01 |
description |
PurposeA nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP.MethodsWe investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over 38.3℃ with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases.ResultsThere were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender.ConclusionChildren with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children. |
topic |
Asthma Atopy Child Pneumonia Mycoplasma |
url |
http://kjp.or.kr/upload/pdf/kjped-57-271.pdf |
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