Abstract:
BACKGROUND:Mycoplasma pneumoniae is one of the most common pathogens causing community acquired pneumonia in children. Although the rate of macrolide-refractory Mycoplasma pneumoniae (MRMP) has increased, systemic glucocorticoids as a treatment option has not been validated yet. The purpose of this study was to assess the efficacy of glucocorticoids add-on in the treatment of MRMP in children through systematic review and meta-analysis. METHODS:Data sources A systematic literature search was conducted using ten electronic bibliographic databases including English, Korean, Chinese and Japanese languages, up to March 8, 2018. Study selection The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and selected randomized control trials which compared the efficacy of glucocorticoids add-on to macrolide in the treatment of MRMP in children. Data extraction Two independent reviewers extracted: primary outcomes as hospital days, fever duration, and change in C-reactive protein (CRP) and main analysis was performed through meta-analysis with random effects model. RESULTS:Twenty-four unique randomized controlled trials met the inclusion criteria. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in conventional macrolide-treatment group (Weighted mean difference (WMD) = - 4.03 days). The mean length of fever duration was significantly shorter in the glucocorticoid treatment group in comparison with the conventional treatment group (WMD = -3.32 days). Level of CRP after treatment was significantly lower in the glucocorticoid treatment group than that in the conventional treatment group (WMD = -16.03). Sensitivity analysis and subgroup analysis showed no significant improvement in heterogeneity. As limitations of the study, most of the studies included were from a single country and we were unable to control for heterogeneity across interventions, lack of standardized measures, and different time points of assessments across studies. CONCLUSIONS:Glucocorticoid add-on treatment for MRMP can significantly shorten the duration of fever and hospital stay and decrease the level of CRP. These results should be confirmed by adequately powered studies in the future.
journal_name
BMC Pulm Medjournal_title
BMC pulmonary medicineauthors
Kim HS,Sol IS,Li D,Choi M,Choi YJ,Lee KS,Seo JH,Lee YJ,Yang HJ,Kim HHdoi
10.1186/s12890-019-0990-8subject
Has Abstractpub_date
2019-12-18 00:00:00pages
251issue
1issn
1471-2466pii
10.1186/s12890-019-0990-8journal_volume
19pub_type
杂志文章,meta分析abstract:BACKGROUND:The incidence and prevalence of chronic kidney disease (CKD) continue to rise worldwide. Increasing age, diabetes, hypertension, and cigarette smoking are well-recognized risk factors for CKD. Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation leading to airway obstr...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12890-016-0315-0
更新日期:2016-11-24 00:00:00
abstract:BACKGROUND:Despite advances in asthma treatment, severe asthma (SA) still results in high morbidity and use of health resources. Our hypothesis was that SA patients would achieve adequate control with a systematic protocol, including oral corticosteroids, budesonide/formoterol maintenance and reliever therapy and a mul...
journal_title:BMC pulmonary medicine
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/s12890-017-0380-z
更新日期:2017-02-15 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,已发布勘误
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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更新日期:2018-12-04 00:00:00
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journal_title:BMC pulmonary medicine
pub_type: 杂志文章
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更新日期:2018-01-16 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2018-04-17 00:00:00
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journal_title:BMC pulmonary medicine
pub_type: 杂志文章
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更新日期:2019-06-17 00:00:00
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