According to media reports, the incidence rate of mycoplasma pneumonia has risen recently, and children's hospitals in Beijing, Shanghai, Guangzhou and other places have ushered in a small peak of visits, with children crowded into hospitals in many places.

The discussion on the topic of "Mycoplasma pneumonia epidemic" on the internet remains hot, and there are rumors that azithromycin is out of stock

"Will mycoplasma pneumonia break out like COVID-19?", "How should children at home prevent it?", "What should we do if children eat azithromycin for three days or cough?"

01

Mycoplasma pneumonia is prevalent, with school-age children being the high-risk population

We saw in the pediatric respiratory department that although it was a weekday morning, there were many patients seeking medical treatment. A long queue formed in front of the nurse station, and nurses were busy registering and calling their numbers.

The corridor at the entrance of the clinic was bustling with people, and the waiting seats were also filled with parents and children. Coughing sounds kept coming and going, and some children were crying.

The throat swab sampling room is also very busy, filled with children and parents waiting for testing. However, the queue is moving very fast. One parent revealed that he and his son waited in less than 10 minutes from queuing to completing the test.

According to observation, most of the children who come for medical treatment are around 5 years old, and there are also elementary school students around 10 years old. There are fewer infants and young children, and parents' expressions are relatively calm and relaxed. Although the department is quite crowded, the order is well-organized.

Mr. Qu, who brought his 7-year-old daughter to the hospital for treatment, said that his daughter came home from school a few days ago and complained of sore throat. She started coughing and having a runny nose at night, but did not have a fever. He didn't know if she was infected with mycoplasma and didn't dare to take antibiotics indiscriminately. So he quickly made an appointment to see a doctor.

Another parent, Ms. Zhu, said that her son was in third grade when he suddenly had a high fever for two days last week. He had a slight cough, but after taking antipyretic medicine, he no longer had a fever. He also had gastrointestinal problems and vomited when eating. At first, she thought it was gastroenteritis, but she heard that several classmates in the class were coughing and having a fever. Her husband suspected it was mycoplasma infection and asked her to take the child to the respiratory department for examination.

Experts have revealed that there has been an outbreak of mycoplasma around three months ago, with a higher proportion of children being infected during their preschool and school years. Some children have developed lung consolidation, which is partially white lung.

Experts also stated that there is currently no shortage of azithromycin supply in the hospital. "There are rumors that azithromycin is out of stock, but our patients have not run out of stock, whether they buy imported or domestic drugs themselves

Why did Mycoplasma pneumoniae suddenly become popular?

During an interview, a parent revealed to 39 Deep Breath that their child's health has always been good. When the flu was prevalent before, their child was also fine. "I didn't expect Mycoplasma to be so powerful, and they managed to avoid H1N1, but not Mycoplasma.

Experts suggest that there are several reasons for the sudden increase in Mycoplasma pneumonia infections this year

Mycoplasma infection is a common childhood infection. Before the COVID-19 epidemic, Mycoplasma pneumoniae may be epidemic once every 4-6 years, and other viruses will also be epidemic once.

A few years ago, due to strict epidemic prevention and control measures, many children did not go to school and wore masks, which reduced the stimulation of many bacteria.

After the epidemic was lifted, children went to school, and coupled with the recent cooler weather, everyone likes to gather indoors for activities, which increases the infectivity of bacteria.

In addition to Mycoplasma, there have also been occasional outbreaks of viruses such as Pseudomonas aeruginosa, syncytial virus, and adenovirus this year. However, this time the Mycoplasma epidemic lasted for a longer period of time and received higher social attention.

In addition, after the epidemic, people's health awareness has improved and they have begun to pay attention to pathogen testing. This year, the level of testing has also improved. In the past, it may not be known what pathogen it was after being cured, but now medical methods can detect it as mycoplasma.

Therefore, experts suggest that parents should take their children to crowded and enclosed places less, go to parks more, and bask in the sun more. If there is no large-scale epidemic of pneumonia in the school class, you can still go to school, but you need to wear a mask, wash your hands frequently, and ventilate more. Parents should attach great importance to children with a clear history of contact, and seek medical attention and treatment as soon as corresponding symptoms appear.

If you suspect that you have been infected with Mycoplasma, how should you test yourself? Experts say that hospitals currently have many testing methods, such as throat swabs, blood tests, sputum tests, bronchoalveolar lavage fluid tests, etc. If it is an early infection, it is recommended that everyone go to the hospital for mycoplasma nucleic acid testing.

03

Is it rumored online that azithromycin is resistant? Can it still be eaten?

Azithromycin is one of the preferred drugs for treating mycoplasma pneumonia. According to the "Diagnosis and Treatment Guidelines for Mycoplasma Pneumonia in Children (2023 Edition)" released by the National Health Commission, macrolide antibiotics including azithromycin, clarithromycin, erythromycin, etc. are listed as the preferred treatment for Mycoplasma Pneumonia. However, some parents have reported that their children have developed resistance to azithromycin.

A parent said on social media that their child discovered a lung infection on the third day after experiencing fever symptoms and was admitted to the hospital for treatment. However, after using azithromycin continuously for 5 days, there was no effect. Later, the doctor adjusted the medication and the child's symptoms improved significantly.

Experts believe that the reason for this phenomenon is not only the widespread use of azithromycin, but also the incorrect medication method of parents. "Azithromycin has different usage methods, including taking it for 3 days and stopping for 4 days, or taking it for 5 days and stopping for 2 days. If parents cannot strictly follow the drug instructions to take the medication, it is easy to develop corresponding resistance risks

Experts suggest that the current societal perception of "azithromycin resistance" may also be related to the anxiety of some parents. During the process of diagnosis and treatment, experts encountered some parents who were very nervous and anxious, worried that their children would not go to school for several days and fall behind in too many classes. They hoped that the medication would immediately cure the illness and had high expectations for its effectiveness.

The general course of treatment for azithromycin is to take it for 3 days and stop for 4 days, requiring 2-3 courses. This is our classic treatment. For severely ill children, it can be extended for 2 days and taken for 5 days, depending on the doctor's judgment. However, many parents start to feel anxious when their children are still within the normal course of treatment

Experts believe that even if a child has some resistance genes in their body, it does not mean that taking the drug is useless. There have been cases in clinical practice where "resistance genes were discovered, but azithromycin was also effective". He suggested that parents should pay attention to observing their children after taking azithromycin to determine if there is any improvement. If there is improvement, it proves that it is not drug resistance.

How to determine if there is improvement? The key is to consider these three points:

(1) Check if the body temperature has been consistently above 39 ℃. If it drops from 40 ℃ to 38 ℃, although the fever does not subside, it does not continue to rise, which is a sign of improvement;

(2) Check the frequency of fever. For example, what used to burn a few times a day is now only burned once a day, which is also a trend of improvement;

(3) Looking at the mental state during a fever, such as being able to eat, sleep, play, and have fun despite having a fever of 38 ℃, these are all signs of improvement. If you don't eat or drink, vomit, have a bad mood, and sleep all day when you have a fever, this is a bad situation.

Director Zeng Qiang emphasized that if the child's condition is improving, they must adhere to azithromycin treatment and take enough courses to prevent recurrence.

Experts say that it is "not advisable" for some parents to frequently change their medication and switch to tetracycline and other drugs on their own. Because tetracycline is contraindicated for children under 8 years old, it can damage tooth enamel and sometimes deposit on bones. He suggests that children under 8 years old should first choose macrolide drugs such as azithromycin, clarithromycin, and erythromycin.

In addition, if the medication is changed frequently and has not yet reached the effective blood drug concentration, the effect after changing the medication is actually not good, and it is more likely to develop drug resistance.

How to prevent mycoplasma pneumonia? Experts suggest that children can not only wear masks, wash their hands more, ventilate more, and avoid going to enclosed places in daily life, but also receive vaccinations.

"Our vaccines are very perfect now. Most of them are used to prevent infection. There are 13 valent pneumonia vaccine, 23 valent pneumonia vaccine, DPT vaccine, etc. to prevent respiratory tract infection, hepatitis B vaccine, and digestive tract infection. These should be played. It can reduce the chances of children's infection. Even if they are infected, they are mild diseases and not easy to leave sequelae."

Mycoplasma pneumoniae infection is a common respiratory infectious diseases in children in China. Experts call on everyone not to be overly anxious. Mycoplasma pneumonia is preventable and treatable, and there are very few cases of sequelae. After one infection, the probability of re infection is also relatively low within 3 months to 6 months. As long as it is detected early and given comprehensive treatment, the vast majority of children can achieve complete recovery.