THE EFFECTIVENESS OF USING PREDNISOLONE IN CHILDREN WITH COMMUNITY

Sadikov N., Xu Chao Yue, Odilov B., Xin Zhi Hong, Zhang Zhao Нua

Email: Sadikov6107@scientifictext.ru

Sadikov Nematullo - Master Degree Student;

Xu Chao Yue - Master Degree Student,

PEDIATRICS FACULTY;

Odilov Bekzod - Master Degree student,

FACULTY OF ENDOCRINOLOGY;

Xin Zhi Hong - Master Degree Student,

PEDIATRICS FACULTY,

SHANDONG UNIVERSITY;

Zhang Zhao Hua – Professor,

PEDIATRICS FACULTY,

SHANDONG UNIVERSITY,

Pediatr,

HOSPITAL № 2,

JINAN, SHANDONG PROVINCE, PEOPLE'S REPUBLIC OF CHINA

Abstract: сommunity-acquired Pneumonia (CAP) is an infection of the lung parenchyma that is acquired outside of hospital,[1] involved approximately 150 million new cases annually, among children younger than 5 years old worldwide. We retrospectively evaluated the effect of Prednisolone in 89 children with CAP who were admitted to the 2^nd hospital of Shandong University (China) and Infectious diseases of Andijon region (Uzbekistan). The mean age was 6.3 in China (Placebo) and 9.3 in Uzbekistan (control) years, 54% and 52% of them were boys respectively. All children had received broad spectrum antibiotics (cephalosporin) or Macrolides (Azithromycin) and Oxygen. In addition to these we added Prednisolone 1 mg/kg on day 2 of admission to control group. 24 (68.5% from all febrile) children were became afebrile within 24 hours after Predisolone use on day 3 of admission, and their clinical status developed in control group, when it was achieved on day 7 in Placebo group. Hospital days also shortened in control group (6 days) than placebo (8 days) (p value ≤ 0.01). In conclusion, steroid therapy helpful for reducing hospital stay and morbidity in children with community-acquired Pneumonia and no observed side effects.

Keywords: рrednisolone, pediatric pneumonia, hospital day, placebo, corticosteroid, hospitalization, temperature, cough, morbidity.

ЭФФЕКТИВНОСТЬ ПРЕДНИЗОЛОНА У ДЕТЕЙ С ВНЕБОЛЬНИЧНОЙ ПНЕВМОНИЕЙ

Садиков Н., Шу Чао Юе, Одилов Б., Шин Жи Хонг, Жанг Жао Хуа

Садиков Неъматулло – магистрант;

Шу Чао Юе – магистрант,

факультет педиатрии;

Одилов Бекзод – магистрант,

факультет эндокринологии

Шин Жи Хонг – магистрант,

факультет педиатрии,

Шандонский университет,

Жанг Жао Хуа – профессор,

факультет педиатрии,

Шандонский университет,

педиатр,

больница № 2,

г. Джинан, провинция Шандонг, Китайская Народная Республика

Аннотация: внебольничная пневмония - это инфекция легочной паренхимы, приобретенной вне медицинских учреждений. Во всем мире ежегодно встречается примерно 150 миллионов новых случаев у детей младше 5 лет. Мы ретроспективно исследовали 89 детей с внебольничной пневмонией, положенных во вторую больницу Шандонского университета (Китай) и Андижанскую областную инфекционную больницу. Средний возраст больных в группе плацебо (в Китае) был 6.3, в контрольной группе (в Андижане) равнялся 9.3 лет жизни. 54% процентов из 46 составили мальчики в группе плацебо, почти такое соотношение (52%) на контрольной группе. Все дети приняли антибиотики (цефалоспорины или азитромицин) и Кислород. Дополнительно к ним мы назначали Преднизолон (1 мг/кг) детям, находящимся в Андижане, со второго дня на больничной койке. У 68.5% детей с повышенной температурой тела улучшилась их температура после принятия преднизолона уже через 24 часа и клинический статус тоже улучшился в контрольной группе. В плацебо группе мы пришли к этому результату на седьмой день госпитализации. Больничные дни тоже стали меньше в контрольной группе, чем в плацебо (6 дней к 8, p value ≤ 0.01). В заключение я хотел бы сказать: кортикостероидная терапия помогла уменьшить больничные дни, заболеваемость и смертность у детей с внебольничной пневмонией, без обнаружения ярко выраженных побочных эффектов.

Ключевые слова: преднизолон, пневмония, плацебо, температура, кортикостероид.

References / Список литературы

Grief S.N. & Loza J.K. Guidelines for the Evaluation and Treatment of Pneumonia. Care - Clin. Off. Pract. 45, 485–503 (2018).
Lodha R., Kabra S.K. & Pandey R.M. Antibiotics for community-acquired pneumonia in children. Cochrane Database Syst. Rev. 2013 (2013).
Harris M. et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: Update 2011. Thorax 66 (2011).
Liu L. et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: An updated systematic analysis. Lancet 385. 430–440 (2015).
Brar N.K. & Niederman M.S. Management of community-acquired pneumonia: A review and update. Adv. Respir. Dis. 5, 61–78 (2011).
Nascimento-Carvalho C.M. Community-acquired pneumonia among children: the latest evidence for an updated management. Pediatr. (Rio. J). 96, 29–38 (2020).
Ostermann H. et al. Resource use by patients hospitalized with community-acquired pneumonia in Europe: Analysis of the REACH study. BMC Pulm. Med. 14, (2014).
Sabry N.A. & Omar E.E.-D. Corticosteroids and ICU Course of Community Acquired Pneumonia in Egyptian Settings. & Pharm. 02, 73–81 (2011).
Confalonieri M. et al. Hydrocortisone infusion for severe community-acquired pneumonia: A preliminary randomized study. J. Respir. Crit. Care Med. 171, 242–248 (2005).
Mikami K. et al. Efficacy of corticosteroids in the treatment of community-acquired pneumonia requiring hospitalization. Lung 185, 249–255 (2007).
Meijvis S.C.A. et al. Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: A randomised, double-blind, placebo-controlled trial. Lancet 377, 2023–2030 (2011).
Torres A. et al. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: A randomized clinical trial. JAMA - J. Am. Med. Assoc. 313, 677–686 (2015).
Snijders D., Daniels J.M.A., De Graaff C.S., Van Der Werf T.S. & Boersma W.G. Efficacy of corticosteroids in community-acquired pneumonia: A randomized double-blinded clinical trial. J. Respir. Crit. Care Med. 181, 975–982 (2010).
Annane D. Corticosteroids and pneumonia: Time to change practice. Lancet 385, 1484–1485 (2015).
Stern A. et al. Corticosteroids for pneumonia. Cochrane Database Syst. Rev. 2017, (2017).
Blum C.A. et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: A multicentre, double-blind, randomised, placebo-controlled trial. Lancet 385, 1511–1518 (2015).
Yuanjing C., Pu H. & Wu T. Corticosteroids for pneumonia. Cochrane Database Syst. Rev. (2009) doi:10.1002/14651858.CD007720.
Siemieniuk R.A.C. et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: A systematic review and metaanalysis. Intern. Med. 163, 519–528 (2015).
Tagarro A. et al. Dexamethasone for Parapneumonic Pleural Effusion: A Randomized, Double-Blind, Clinical Trial. Pediatr. 185, 117-123.e6 (2017).
Nagy B. et al. Efficacy of methylprednisolone in children with severe community acquired pneumonia. Pulmonol. 48, 168–175 (2013).
Nascimento-Carvalho A.C. & Nascimento-Carvalho C.M. Clinical management of community-acquired pneumonia in young children. Expert Opin. Pharmacother. 20, 435–442 (2019).
Radisic M., Torn A., Gutierrez P., Defranchi H.A. & Pardo P. Severe acute lung injury caused by Mycoplasma pneumoniae: potential role for steroid pulses in treatment. Clin. Infect. Dis. an Off. Publ. Infect. Dis. Soc. Am. 31, 1507–1511 (2000).
Tarp B., Jensen J.S., Østergaard L. & Andersen P.L. Search for agents causing atypical pneumonia in HIV-positive patients by inhibitor-controlled PCR assays. Respir. J. 13, 175–179 (1999).
Foy H.M. et al. Mycoplasma pneumoniae Infections in Patients with Immunodeficiency Syndromes : Report of Four Cases Published by : Oxford University Press Stable URL : http://www.jstor.org/stable/30108708 Mycoplasma pneumoniae Infections in Patients with Immunodeficiency. 127, 388–393 (2017).
Denny F.W., Taylor-Robinson D. & Allison A.C. The role of thymus-dependent immunity in Mycoplasma pulmonis infections of mice. Med. Microbiol. 5, 327–336 (1972).
Tanaka H., Honma S.I., Abe S. & Tamura H. Effects of interleukin-2 and cyclosporin A on pathologic features in Mycoplasma pneumonia. J. Respir. Crit. Care Med. 154, 1908–1912 (1996).
Tanaka H. et al. [Therapeutic effectiveness of prednisolone in Mycoplasma pulmonis-infected pneumonia in mice]. Nihon Kyobu Shikkan Gakkai Zasshi 32, 42–47 (1994).
Tanaka H., Koba H., Honma S., Sugaya F. & Abe S. Relationships between radiological pattern and cell-mediated immune response in Mycoplasma pneumoniae pneumonia. Respir. J. 9, 669–672 (1996).
Taylor G. Immunity to mycoplasma infections of the respiratory tract: A review. R. Soc. Med. 72, 520–526 (1979).
Opitz O., Pietsch K., Ehlers S. & Jacobs E. Cytokine gene expression in immune mice reinfected with Mycoplasma pneumoniae: The role of T cell subsets in aggravating the inflammatory response. Immunobiology 196, 575–587 (1997).
Lee K.Y. et al. Role of prednisolone treatment in severe Mycoplasma pneumoniae pneumonia in children. in Pediatric Pulmonology vol. 41 263–268 (2006).
Youn Y.S. et al. Early additional immune-modulators for Mycoplasma pneumoniae pneumonia in children: An observation study. Chemother. 46, 239–247 (2014).
Liverani E., Banerjee S., Roberts W., Naseem K.M. & Perretti M. Prednisolone exerts exquisite inhibitory properties on platelet functions. Pharmacol. 83, 1364–1373 (2012).
You S.Y., Jwa H.J., Yang E.A., Kil H.R. & Lee J.H. Effects of methylprednisolone pulse therapy on refractory Mycoplasma pneumoniae pneumonia in children. Allergy, Asthma Immunol. Res. 6, 22–26 (2014).
Tashiro M. et al. Adjunctive corticosteroid therapy for inpatients with Mycoplasma pneumoniae pneumonia. BMC Pulm. Med. 17, 1–10 (2017).
Bajantri B., Venkatram S. & Diaz-Fuentes G. Mycoplasma pneumoniae : A Potentially Severe Infection . Clin. Med. Res. 10, 535–544 (2018).

Ссылка для цитирования данной статьи

Тип лицензии на данную статью – CC BY 4.0. Это значит, что Вы можете свободно цитировать данную статью на любом носителе и в любом формате при указании авторства.

Электронная версия. Sadikov N., Xu Chao Yue, Odilov B., Xin Zhi Hong, Zhang Zhao Нua THE EFFECTIVENESS OF USING PREDNISOLONE IN CHILDREN WITH COMMUNITY–ACQUIRED PNEUMONIA // Вестник науки и образования № 4(107), 2021 [Электронныйресурс].URL: http://scientificjournal.ru/images/PDF/2021/107/the-effectiveness-of-usi.pdf (Дата обращения:ХХ.ХХ.201Х).

Печатная версия. Sadikov N., Xu Chao Yue, Odilov B., Xin Zhi Hong, Zhang Zhao Нua THE EFFECTIVENESS OF USING PREDNISOLONE IN CHILDREN WITH COMMUNITY–ACQUIRED PNEUMONIA // Вестник науки и образования № 4(107), 2021, C. {см. журнал}.