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Mycoplasma pneumoniae 폐렴으로 입원한 소아의 Macrolide 내성과 치료 양상
강국진 ( Kook Jin Kang ),고정희 ( Jeong Hee Ko ),최경은 ( Kyong Eun Choi ),최유미 ( Yu Mi Choi ),이원욱 ( Won Wuk Lee ) 중앙대학교 의학연구소 2018 中央醫大誌 Vol.43 No.1
Pediatric Mycoplasma pneumoniae (M. pneumoniae) infection in Korea is becoming difficult to treat due to the recent rise in macrolide resistance. In this study, we investigated the macrolide resistance rate, clinical features, and treatment response of mycoplasma pneumonia patients. The 23S rRNA gene mutations in 247 patients with M. pneumoniae pneumonia were analyzed and grouped into either macrolide-resistant mycoplasma pneumonia (MRMP) and macrolide-susceptible mycoplasma pneumonia (MSMP) patients. Among patients with mycoplasma pneumonia, 85.8% had MRMP and all were mutations of A2063G. All patients received macrolide antibiotics and received steroid therapy in patients with unresponsive to macrolide. Total fever days was significantly longer in MRMP (7.3 days) than in MSMP (5.6 days, p = 0.009), and febrile days after initiation of macrolides was longer in MRMP (2.1 days) than that of MSMP (1.1 days, p = 0.003). In laboratory finding, only lactate dehydrogenase was significantly higher in MRMP (p = 0.026). The steroid treatment rate was significantly higher in MRMP (36.7%) than MSMP (14.2%) (p = 0.011) and the duration of use was significantly longer in MRMP (3 days) than MSMP (1 day, p = 0.039). The results of this study suggest that steroid therapy can help lower the duration of total treatment in children with macrolide-resistant mycoplasma pneumonia. Chung-Ang J Med 2018; 43(1): 7-13
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