Clinical and Experimental Pediatrics
- 제46권7호
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- Pages.710-713
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- 2003
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- 2713-4148(eISSN)
소아 쯔쯔가무시병에서 록시쓰로마이신 치료
Roxithromycin Treatment of Tsutsugamushi Disease (Scrub Typhus) in Children
- Park, Hye-Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
- Lee, Kyung-Yil (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
- 투고 : 2003.03.04
- 심사 : 2003.04.30
- 발행 : 2003.07.15
초록
목 적 : 쯔쯔가무시병의 치료제로는 클로람페니콜 또는 독시싸이클린이 사용되고 있으나 소아에서는 재생불량성 빈혈의 위험성, 치아 착색 등의 합병증으로 연령에 따라 치료제의 선택에 어려움을 겪을 수 있다. 새로운 마크로라이드계 항생제의 하나인 록시쓰로마이신의 쯔쯔가무시병 환아에 대한 치료 효과을 알아보고자 하였다. 방 법 : 쯔쯔가무시병으로 치료받은 환아 39명을 대상으로 치료 약제에 따라 독시싸이클린으로 치료받은 16명(DC군), 클로람페니콜로 치료받은 14명(CM군)과 록시쓰로마이신으로 치료받은 9명(RM군)으로 나눈 후 각군의 평균 나이, 입원 전 발열일, 백혈구 수, 비정상 간효소치를 포함한 합병증 및 치료 시작 후 해열 시간을 후향적으로 비교하였다. 결 과 : 환아의 평균 연령은
Purpose : Although chloramphenicol and doxycycline have been used for the treatment of tsutsugamuchi disease, a difficulty exists in determining which drugs to use in treating children because of potential complications such as aplastic anemia or teeth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on tsutsugamushi disease in children. Methods : A retrospective analysis was conducted on 39 children with tsutsugamuchi disease(scrub typhus) who were treated with doxycycline(DC), chloramphenicol(CM), or roxythromycin(RM) between 1991 and 2000. We divided the patients into a DC-treated group(DC group; 16 children), a CM-treated group(CM group; 14 children), and RM-treated group(RM group; 9 children) and compared these groups. Results : Most cases(97%) developed in October and November. Fever and rash were observed in all 39 cases and an eschar was noted in 36 cases(92%). No statistical differences could be found between the three groups in mean age, duration of fever before admission, white blood cell(WBC) count, and complications including abnormal liver enzymes. In most cases defervescence after treatment was within 24 hours(34 cases, 87%), and during 24-48 hours in two cases in the DC group, one in the CM group, and two in the RM group(no statistical difference). Conclusion : Roxythromycin was as effective as conventional doxycycline or chloramphenicol, in children with scrub typhus and may be safer to use.