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Overview of antimicrobial options for Mycoplasma pneumoniae pneumonia: focus on macrolide resistance.
Clin Respir J. 2017 Jul; 11(4):419-429.CR

Abstract

BACKGROUND AND AIMS

Community-acquired pneumonia (CAP) is a common infectious disease affecting children and adults of any age. Mycoplasma pneumoniae has emerged as leading causative agent of CAP in some region, and the abrupt increasing resistance to macrolide that widely used for management of M. pneumoniae has reached to the level that it often leads to treatment failures.

OBJECTIVE

We aim to discuss the drivers for development of macrolide-resistant M. pneumoniae, antimicrobial stewardship and also the potential treatment options for patients infected with macrolide-resistant M. pneumonia.

METHODS

The articles in English and Chinese published in Pubmed and in Asian medical journals were selected for the review.

RESULTS

M. pneumoniae can develop macrolide resistance by point mutations in the 23S rRNA gene. Inappropriate and overuse of macrolides for respiratory tract infections may induce the resistance rapidly. A number of countries have introduced the stewardship program for restricting the use of macrolide. Tetracyclines and fluoroquinolones are highly effective for macrolide-resistant strains, which may be the substitute in the region of high prevalence of macrolide-resistant M. pneumoniae.

CONCLUSION

The problem of macrolide resistant M. pneumonia is emerging. Antibiotic stewardship is needed to inhibit the inappropriate use of macrolide and new antibiotics with a more acceptable safety profile for all ages need to be explored.

Authors+Show Affiliations

Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China. Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.Department of Microbiology, UZ Leuven, Leuven, Belgium.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26365811

Citation

Cao, Bin, et al. "Overview of Antimicrobial Options for Mycoplasma Pneumoniae Pneumonia: Focus On Macrolide Resistance." The Clinical Respiratory Journal, vol. 11, no. 4, 2017, pp. 419-429.
Cao B, Qu JX, Yin YD, et al. Overview of antimicrobial options for Mycoplasma pneumoniae pneumonia: focus on macrolide resistance. Clin Respir J. 2017;11(4):419-429.
Cao, B., Qu, J. X., Yin, Y. D., & Eldere, J. V. (2017). Overview of antimicrobial options for Mycoplasma pneumoniae pneumonia: focus on macrolide resistance. The Clinical Respiratory Journal, 11(4), 419-429. https://doi.org/10.1111/crj.12379
Cao B, et al. Overview of Antimicrobial Options for Mycoplasma Pneumoniae Pneumonia: Focus On Macrolide Resistance. Clin Respir J. 2017;11(4):419-429. PubMed PMID: 26365811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overview of antimicrobial options for Mycoplasma pneumoniae pneumonia: focus on macrolide resistance. AU - Cao,Bin, AU - Qu,Jiu-Xin, AU - Yin,Yu-Dong, AU - Eldere,Johan Van, Y1 - 2015/10/13/ PY - 2015/06/11/received PY - 2015/08/20/revised PY - 2015/09/07/accepted PY - 2015/9/15/pubmed PY - 2018/4/24/medline PY - 2015/9/15/entrez KW - atypical - community-acquired pneumonia - fluoroquinolones - macrolides - macrolide-resistant Mycoplasma pneumoniae - resistance - tetracyclines SP - 419 EP - 429 JF - The clinical respiratory journal JO - Clin Respir J VL - 11 IS - 4 N2 - BACKGROUND AND AIMS: Community-acquired pneumonia (CAP) is a common infectious disease affecting children and adults of any age. Mycoplasma pneumoniae has emerged as leading causative agent of CAP in some region, and the abrupt increasing resistance to macrolide that widely used for management of M. pneumoniae has reached to the level that it often leads to treatment failures. OBJECTIVE: We aim to discuss the drivers for development of macrolide-resistant M. pneumoniae, antimicrobial stewardship and also the potential treatment options for patients infected with macrolide-resistant M. pneumonia. METHODS: The articles in English and Chinese published in Pubmed and in Asian medical journals were selected for the review. RESULTS: M. pneumoniae can develop macrolide resistance by point mutations in the 23S rRNA gene. Inappropriate and overuse of macrolides for respiratory tract infections may induce the resistance rapidly. A number of countries have introduced the stewardship program for restricting the use of macrolide. Tetracyclines and fluoroquinolones are highly effective for macrolide-resistant strains, which may be the substitute in the region of high prevalence of macrolide-resistant M. pneumoniae. CONCLUSION: The problem of macrolide resistant M. pneumonia is emerging. Antibiotic stewardship is needed to inhibit the inappropriate use of macrolide and new antibiotics with a more acceptable safety profile for all ages need to be explored. SN - 1752-699X UR - https://www.unboundmedicine.com/medline/citation/26365811/Overview_of_antimicrobial_options_for_Mycoplasma_pneumoniae_pneumonia:_focus_on_macrolide_resistance_ DB - PRIME DP - Unbound Medicine ER -