Combined Treatment for Child Refractory Mycoplasma pneumoniae Pneumonia With Ciprofloxacin and Glucocorticoid

Objects: 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. Conclusion: 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. Pediatr Pulmonol. 2011;46:1093-1097. (C) 2011 Wiley Periodicals, Inc.