[Community-acquired pneumonia in children: importance of Mycoplasma pneumoniae infections and efficacy of antibiotics].
OBJECTIVE
Define a therapeutic management schema adapted to children with community-acquired pneumonia.


METHODS
A prospective survey was conducted in 104 children over 18 months of age with community-acquired pneumonia. The pathogen was isolated in 85% of the cases.


RESULTS
Viral infection alone was proven in 30 children (respiratory syncytial virus in 10). Pneumococci pneumonia was found in 12 patients; the isolated strains were sensitive to penicillin. Apyrexia was obtained in 11/12 cases with amoxicillin. Mycoplasma infections occurred in 42% of the cases (41 alone and in association with pneumococci in 2 cases). Pneumococci and mycoplasma infections could not be differentiated with standard radiography and laboratory tests. Initial treatment with beta lactamines was always unsuccessful in children with mycoplasma infections. Apyrexia was achieved when antibiotics were changed to macrolides.


CONCLUSIONS
Since lower respiratory tract infections due to pneumococci are much more severe than those due to mycoplasma, beta lactamines should be given as first intention treatment for children over 18 months with pneumonia. Macrolides should be given in case of failure because mycoplasma would then be the most probable infectious agent.
Gendrel
D
D
Service de Pédiatrie, Hôpital Saint-Vincent-de-Paul, Paris.
Raymond
J
J
Moulin
F
F
Iniguez
J L
JL
Truong
M
M
Ravilly
S
S
Chaussain
M
M
Lebon
P
P
Kalifa
G
G
D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology / Q000821:virology; D006801:Humans; D007223:Infant; D010406:Penicillins / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy*; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000821:virology; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D010406:Penicillins; D000658:Amoxicillin
Pneumonies communautaires de l'enfant: importance des infections à Mycoplasma pneumoniae et efficacité des antibiotiques.