title: Combined treatment for child refractory Mycoplasma pneumoniae pneumonia with ciprofloxacin and glucocorticoid.
abstract: OBJECTIVE
  To evaluate the efficacy of combined treatment of ciprofloxacin and glucocorticoid for child refractory Mycoplasma pneumoniae (M. pneumoniae) pneumonia.
  
  
  METHODS
  Clinical and laboratory characteristics of six pediatric refractory M. pneumoniae pneumonia cases treated with ciprofloxacin and glucocorticoids were reported.
  
  
  RESULTS
  Five cases complicated with pleural effusion. The average febrile period prior to admission was 8.5 ± 2.0 days, the average total febrile period was 14.6 ± 7.6 days, and the average febrile period after treatment was 3.3 ± 3.0 days. The average time in hospital for patients was 23.6 ± 4.8 days. The initial mean WBC count was 10,100 ± 2,400/mm(3) . The erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), and C-reactive protein (CRP) in all cases were elevated during the course of illness. After combined therapy, all children clinically improved, with resolution of radiographic findings and normal laboratory items. We analyzed the 23S rRNA gene in four nasopharyngeal secretions, and found mutations in A2063G of domain V in three cases, and mutation in A2064G in the other case.
  
  
  CONCLUSIONS
  Combined treatment of ciprofloxacin and glucocorticoids can significantly ameliorate child refractory M. pneumoniae pneumonia further comparative study is needed to well evaluate the treatment efficacy.
authors.affiliation: Respiratory Department, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Aizhen
authors.initials: A
authors.lastname: Lu
authors.forename: Libo
authors.initials: L
authors.lastname: Wang
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhang
authors.forename: Mingzhi
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D009154:Mutation; D009177:Mycoplasma pneumoniae / Q000187:drug effects*; D009305:Nasopharynx / Q000378:metabolism; D010996:Pleural Effusion / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D011019:Pneumonia, Mycoplasma / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D012338:RNA, Ribosomal, 23S; D002939:Ciprofloxacin; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase