[Mycoplasma pneumonia in own clinical material]

Abstract

The majority of community acquired pneumonia patients are treated by family doctors, most frequently in empiric way, what delays the treatment when a choice of antibiotic is not proper. In this case the resistance to the antibiotics of the bacteria can occurred and there is more often the necessity of patient admission to the hospital. The aim of the study was to analyse retrospectively the treatment of mycoplasmal pneumonia patients. The material consisted of consecutive 27 patients (17 females and 10 males; average age 31.9 yrs.) treated in the Pneumonology Department of Medical University of Gdańsk in the period from 1995 to 1997 year because of mycoplasmal pneumonia. The etiologic diagnosis was defined first of all on the base of serologic test, measuring the complement-fixing antibodies, beside clinical data. The retrospective analysis revealed that all patients had been admitted to the hospital after previous not effective anti-bacterial or anti-viral treatment as out-patient. At the admission no patients had the temperature exceeding 38 degrees C, myalgia and headache occurred in 44% and 40.7% of patients respectively, splenomegaly was reported in 4 patients. In chest roentgenograms pulmonary infiltrations were observed in all patients, most frequently unilaterally (68% of pts.), in 29% of patients complicated by pleural effusion. The titers of complement-fixing antibodies against Mycoplasma pneumoniae antigen ranged from 1:245 to 1:2000. In the treatment most frequently (70.3% of cases) doxycycline in monotherapy was used. Eight patients were treated with doxycycline together with erythromycine. In 33.3% patients the antimycoplasmal treatment was ordered only on the base of clinical data. The period of hospitalisation ranged from 18 to 34 days, on an average 24 days.

Conclusion: In case of mild community acquired pneumonias with not defined ethiology, if the initial antibacterial or antiviral treatment is not effective, tetracyclines or/and erythromycine should be ordered without the necessity to confirm the diagnosis of mycoplasamal pneumoniae with the serological test.