海南医科大学学报2025，Vol.31Issue(16)：1263-1270,8.DOI:10.13210/j.cnki.jhmu.20241226.001
左氧氟沙星及多西环素治疗大环内酯类无反应性肺炎支原体肺炎临床分析
The clinical analysis of Levofloxacin and Doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia
摘要
Abstract
Objective:To analyze the clinical efficacy of levofloxacin and doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia(MUMPP)and evaluate their safety in children.Methods:A retro-spective analysis was conducted on clinical data from pediatric patients diagnosed with MUMPP who were hospitalized and treated with doxycycline or levofloxacin at Hainan Women and Children's Medical Center between January 1,2023,to December 31,2023.The mycoplasma pneumoniae(MP)P1 genotype and macrolide resistance genes were detected,and the therapeutic effects of azithromycin,levofloxacin,and doxycycline were compared.Adverse reactions within one year post-treatment were assessed through telephone follow-up.Results:In 2023,a total of 9 732 acute respiratory infection samples were collected,of which 2 700 were MP-positive(infection rate:27.74%).Among these,2 435 cases(90.19%)tested positive for macrolide resistance genes.The infection peaks occurred between June and August,and between October and December,with the majority of cases(40%-50%)involving children aged 3 to 7 years.The infection rate in girls(31.10%)was higher than in boys(24.11%).In a random sample of 400 MUMPP cases,macrolide resistance genes were detected in all patients(A2063G mutation in 398 cases,A2064G mutation in 2 cases).P1 genotype analysis showed that the dominant strains were of the 1a and 2g2 types.Compared to azithromy-cin,both levofloxacin and doxycycline groups showed faster fever resolution.Follow-up results indicated that 9 patients(4.5%)in the levofloxacin group experienced transient leg pain,which resolved after discontinuing treatment.MP is a common respiratory pathogen in children,and the prevalence of MP in Hainan exhibits seasonal patterns.The predominant strains in MUMPP patients were MP types 1a and 2g2,all of which carried macrolide resistance genes.Levofloxacin and doxycycline were highly effective in treating MUMPP and demonstrated a favorable safety profile for short-term use.Conclusion:Levofloxacin and doxycycline dem-onstrated superior clinical efficacy in treating MUMPP in children,with faster symptom relief compared to azithromycin.Both drugs were well-tolerated in short-term use,making them viable alternatives for treating MUMPP in pediatric patients,especially in regions with high macrolide resistance.Further studies with larger sample sizes are needed to confirm these findings.关键词
左氧氟沙星/多西环素/大环内酯类药物无反应性肺炎支原体肺炎/儿童/超说明书用药Key words
Levofloxacin/Doxycycline/Macrolide-unresponsive Mycoplasma pneumoniae pneumonia/Children/Off-label use分类
医药卫生引用本文复制引用
林秋玉,海元平,李永秀,李虹艾,陈金妮,向夏雨,符增珍,尹飞飞,向伟..左氧氟沙星及多西环素治疗大环内酯类无反应性肺炎支原体肺炎临床分析[J].海南医科大学学报,2025,31(16):1263-1270,8.基金项目
This study was supported by Health Science and Technology Innovation Joint Project of Hainan Province(WSJK2024MS214) （WSJK2024MS214）
Chinese Academy of Medical Sciences Type Basic Research Expenses for Central Public Welfare Research Institutes(2022NHCTDCKFKT 31004) （2022NHCTDCKFKT 31004）
Major Science and Technology Project of Hainan Province(ZDKJ2019010) 海南省卫生健康科技创新联合项目(WSJK2024MS214) （ZDKJ2019010）
中国医学科学院中央公益性科研院所基本科研经费(2022NHCTDCK-FKT31004) （2022NHCTDCK-FKT31004）
海南省重大科技项目(ZDKJ2019010) （ZDKJ2019010）
