PDF(Pubmed)
Abstract：
Omadacycline is a novel tetracycline antibiotic that exhibits good in vitro antibacterial activity against atypical pathogens such as Mycoplasma pneumoniae. It is approved for the treatment of adults with community-acquired bacterial pneumonia. However, the safety and efficacy of omadacycline in pediatric patients under 18 years of age have not yet been established. In the present paper, we report a case of pediatric community-acquired pneumonia in which initial empirical anti-infective therapy had failed. The patient received empirical anti-infective therapy with azithromycin and other antimicrobial agents upon admission but showed a poor clinical response and developed secondary tinnitus and liver dysfunction. After the confirmation of M. pneumoniae infection through metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid, an antibiotic switch to omadacycline was made. Thereafter, the patient\'s condition improved, and no adverse reactions were observed. These findings demonstrate that mNGS enables the identification of infection-causing pathogens in patients with unresponsive pneumonia. Omadacycline can be considered as an alternative option for anti-infective therapy in pediatric M. pneumoniae pneumonia, especially when the presence of bacterial resistance, adverse drug reactions, or organ failure are taken into consideration.
摘要：
Omadacycline是一种新型四环素类抗生素，对肺炎支原体等非典型病原体具有良好的体外抗菌活性。它被批准用于治疗患有社区获得性细菌性肺炎的成年人。然而,奥马环素在18岁以下儿童患者中的安全性和有效性尚未确定.在本论文中，我们报道了一例儿童社区获得性肺炎,最初的经验性抗感染治疗失败.患者入院后接受了阿奇霉素和其他抗菌药物的经验性抗感染治疗，但临床反应较差，并出现继发性耳鸣和肝功能障碍。通过支气管肺泡灌洗液的宏基因组下一代测序（mNGS）确认肺炎支原体感染后，将抗生素转换为omadacycline。此后,病人的病情好转，未观察到不良反应。这些发现表明，mNGS能够识别无反应肺炎患者中引起感染的病原体。Omadacycline可作为小儿肺炎支原体肺炎抗感染治疗的替代选择。特别是当细菌耐药性的存在，药物不良反应,或考虑器官衰竭。
