Characteristics of respiratory syncytial virus-induced bronchiolitis co-infection with Mycoplasma pneumoniae and add-on therapy with montelukast.

Abstract

BACKGROUND:

The influence of Mycoplasma pneumoniae (MP) infection on bronchiolitis remains unclear. Additionally, reports on the efficacies of leukotriene receptor antagonists in the treatment of bronchiolitis have been inconclusive.

METHODS:

Children with respiratory syncytial virus (RSV)-induced bronchiolitis were divided into two groups: RSV+MP group and RSV group. Each group was randomly divided into two subgroups: one received routine and placebo treatment, while the other received routine and montelukast treatment for 9 months. The cumulative numbers of wheezing episodes and recurrent respiratory tract infections were recorded. Blood parameters were determined.

RESULTS:

Patients in the RSV+MP group exhibited an older average age, fever, more frequent flaky and patchy shadows in chest X-rays, more frequent extrapulmonary manifestations, and longer hospital stays compared with patients in the RSV group. Additionally, higher baseline blood eosinophil counts, eosinophil cationic protein (ECP), total immunoglobulin E (IgE), interleukin (IL)-4, IL-5, IL-4/interferon-γ ratios, leukotriene (LT) B4, and LTC4, and lower baseline lipoxin A4 (LXA4)/LTB4 ratios were observed in the RSV+MP group compared with the RSV group. Montelukast treatment decreased the cumulative numbers of recurrent wheezing episodes and recurrent respiratory tract infections at 9 and 12 months. This efficacy may be related to the montelukast-induced reductions in peripheral eosinophil counts, ECP and total IgE, as well as the montelukast-dependent recovery in T helper (Th) 1/Th2 balance and LXA4/LTB4 ratios in children with bronchiolitis.

CONCLUSIONS:

RSV bronchiolitis with MP infection was associated with clinical and laboratory features that differed from those of RSV bronchiolitis without MP infection. Add-on therapy with montelukast for 9 months was beneficial for children with bronchiolitis at 9 and 12 months after the initiation of treatment.

• Authors: Sheng-Hua Wu, Xiao-Qing Chen, Xia Kong, Pei-Ling Yin, Ling Dong, Pei-Yuan Liao, Jia-Ming Wu
• Journal: World journal of pediatrics : WJP (World J Pediatr) Vol. 12 Issue 1 Pg. 88-95 (Feb 2016) ISSN: 1867-0687 [Electronic] Switzerland
• PMID: 25846070 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Acetates
• Cyclopropanes
• Leukotriene Antagonists
• Quinolines
• Sulfides
• montelukast

Topics

• Acetates (therapeutic use)
• Bronchiolitis (drug therapy, virology)
• Coinfection
• Cyclopropanes
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Humans
• Infant
• Leukotriene Antagonists (therapeutic use)
• Male
• Pneumonia, Mycoplasma (complications)
• Prospective Studies
• Quinolines (therapeutic use)
• Respiratory Syncytial Virus Infections (complications, drug therapy)
• Sulfides