Macrolide therapy and outcomes in a multicenter cohort of children hospitalized with Mycoplasma pneumoniae pneumonia.

Authors:
Address: Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Samir.shah@cchmc.org
Journal:

Publication:

abstract

BACKGROUND:

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in childhood. Few studies have addressed the association of antimicrobial treatment and outcomes.

OBJECTIVE:

To determine whether Macrolide therapy is associated with improved outcomes among children hospitalized with M. pneumoniae pneumonia.

DESIGN:

multicenter retrospective cohort study.

SETTING:

Thirty-six children's hospitals which contribute data to the Pediatric Health Information System.

PATIENTS:

Children 6-18 years of age discharged with a diagnosis of M. pneumoniae pneumonia.

MAIN EXPOSURE:

Initial macrolide therapy.

MAIN OUTCOME MEASURES:

Length of stay (LOS), all-cause readmissions, and asthma-related hospitalizations.

RESULTS:

Empiric macrolide therapy was administered to 405 (58.7%) of 690 patients. The median LOS was 3 days (interquartile range, 2-6 days). Eight (1.2 %) patients were readmitted within 28 days, and 160 (23.2%) were readmitted within 15 months of index discharge. Ninety-five (13.7%) patients were hospitalized for asthma within 15 months of index discharge. Empiric macrolide therapy was associated with a 32% shorter overall LOS (adjusted beta-coefficient, -0.38; 95% confidence interval [CI]: -0.59 to -0.17). Macrolide therapy was not associated with all-cause readmission at 28 days (adjusted odds ratio, 1.12; 95% CI: 0.22-5.78) or 15 months (adjusted odds ratio, 1.00; 95% CI: 0.59-1.70) or with asthma-related hospitalizations at 15 months (adjusted odds ratio, 0.85; 95% CI: 0.36-1.97).

CONCLUSION:

In this large multicenter study of children hospitalized with M. pneumoniae pneumonia, empiric macrolide therapy was associated with a shorter hospital LOS. Macrolide therapy was not associated with 28-day or 15-month hospital readmission.

Related Articles
Adjunct corticosteroids in children hospitalized with community-acquired pneumonia.
Pediatrics. 2011
Adjunct corticosteroids in children hospitalized with community-acquired pneumonia.
Weiss AK, Hall M, Lee GE, Kronman MP, Sheffler-Collins S, Shah SS. Pediatrics. 2011 Feb; 127(2):e255-63. Epub 2011 Jan 10.
Primary early thoracoscopy and reduction in length of hospital stay and additional procedures among children with complicated pneumonia: results of a multicenter retrospective cohort study.
Arch Pediatr Adolesc Med. 2008
Primary early thoracoscopy and reduction in length of hospital stay and additional procedures among children with complicated pneumonia: results of a multicenter retrospective cohort study.
Shah SS, DiCristina CM, Bell LM, Ten Have T, Metlay JP. Arch Pediatr Adolesc Med. 2008 Jul; 162(7):675-81.
Hospital-level compliance with asthma care quality measures at children's hospitals and subsequent asthma-related outcomes.
JAMA. 2011
Hospital-level compliance with asthma care quality measures at children's hospitals and subsequent asthma-related outcomes.
Morse RB, Hall M, Fieldston ES, McGwire G, Anspacher M, Sills MR, Williams K, Oyemwense N, Mann KJ, Simon HK, et al. JAMA. 2011 Oct 5; 306(13):1454-60.
Review How good is the evidence for the recommended empirical antimicrobial treatment of patients hospitalized because of community-acquired pneumonia? A systematic review.
J Antimicrob Chemother. 2003
Review How good is the evidence for the recommended empirical antimicrobial treatment of patients hospitalized because of community-acquired pneumonia? A systematic review.
Oosterheert JJ, Bonten MJ, Hak E, Schneider MM, Hoepelman IM. J Antimicrob Chemother. 2003 Oct; 52(4):555-63. Epub 2003 Sep 12.
Review Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children.
Cochrane Database Syst Rev. 2010
Review Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children.
Mulholland S, Gavranich JB, Chang AB. Cochrane Database Syst Rev. 2010 Jul 7; (7):CD004875. Epub 2010 Jul 7.

To top • Home

TraveldoctorOnline 2001 • Disclaimer • webmaster

The contents within traveldoctoronline are presented only for informational purposes and cannot substitute for professional health care or any other medical treatment.All users of this website with health problems should be oblige always to consult their medical doctor before starting any treatment.