A Promising Candidate in the Treatment of Children with Bronchopneumonia: Erythromycin Plus PIP/TAZ.

Objective: To investigate the efficacy of piperacillin-tazobactam (PIP/TAZ) versus PIP/TAZ plus erythromycin in the treatment of children with bronchopneumonia, and to evaluate the influence of these treatments on inflammatory factors and intestinal flora. Assessing the impact on these parameters is crucial to provide a comprehensive understanding of the treatment effects.

Methods: A total of 120 children with bronchial pneumonia who were treated in Yichang Central People's Hospital from April 2018 to April 2020 were randomized (1:1) either into the control group or the observation group. The control group was given PIP/TAZ treatment. The observation group was additionally treated with erythromycin on the basis of the control group. The clinical efficacy, disappearance time of main symptoms and signs, inflammatory factors, and intestinal flora before and after treatment were compared between the two groups.

Results: The treatment with PIP/TAZ plus erythromycin led to a significantly higher total clinical effective rate versus PIP/TAZ alone (P < .05). PIP/TAZ plus erythromycin resulted in a shorter time taken for the disappearance of fever, cough, and pulmonary rales versus PIP/TAZ alone (P < .05). These findings suggest that the combination regimen was more effective at resolving the key clinical symptoms of bronchopneumonia in children, which is important for improving patient outcomes and reducing the duration of illness. Patients given PIP/TAZ plus erythromycin experienced lower serum levels of the inflammatory markers CRP, TNF-α, and IL-8 as compared with patients given PIP/TAZ alone (P < .05). The reduction in these inflammatory factors indicates that the addition of erythromycin may have provided greater anti-inflammatory benefits beyond the antimicrobial effects of PIP/TAZ alone. Modulating the inflammatory response is clinically significant, as excessive inflammation can contribute to lung damage and disease severity in pneumonia. Conversely, the observation group showed a higher incidence of gastrointestinal disturbances, including increased stool frequency, watery stools, and elevated stool white blood cell counts after treatment (P < .05), suggesting that the erythromycin component may have disrupted the balance of intestinal flora. Maintaining a healthy gut microbiome is important for overall health, immunity, and preventing further complications. The clinical significance of this finding is that the addition of erythromycin to the treatment regimen may have unintended adverse effects on the gut that should be carefully monitored.

Conclusion: PIP/TAZ plus erythromycin might be a promising candidate in the treatment of children with bronchopneumonia by significantly improving clinical outcomes, shortening the duration of key symptoms, and regulating the level of inflammatory factors. These findings suggest the combination regimen could provide greater clinical benefits compared to PIP/TAZ alone for managing pediatric bronchopneumonia. However, the addition of erythromycin also appeared to aggravate the imbalance of intestinal flora, as evidenced by the increased incidence of gastrointestinal disturbances. Maintaining a healthy gut microbiome is crucial for overall health and immunity in growing children. Therefore, clinicians must carefully weigh the potential benefits of improved antimicrobial and anti-inflammatory effects against the potential risks of disrupting the delicate gut ecosystem when considering the use of antibiotic combinations for pediatric patients. In conclusion, PIP/TAZ plus erythromycin may be a viable treatment option for children with bronchopneumonia, but clinicians should monitor for any unintended impacts on the gut flora and be prepared to make adjustments to the regimen if necessary. Careful consideration of the balance between therapeutic efficacy and preserving intestinal health is essential when prescribing antibiotic combinations, especially in the pediatric population.