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Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.
Expert Rev Anti Infect Ther. 2018 01; 16(1):23-34.ER

Abstract

INTRODUCTION

Mycoplasma pneumoniae is an important cause of community-acquired pneumonia in children and young adolescents. Macrolides are recommended as the first-line therapy however, macrolide resistance rates in M. pneumoniae among children have been increasing substantially. Areas covered: This review focused on clinical characteristics and treatment of macrolide-resistant M. pneumoniae pneumonia in children. Expert commentary: Antibiotic choice should be based on in vitro activity, clinical efficacy and in consideration of potential adverse events. Macrolide resistance did not contribute to the clinical severity of M. pneumoniae pneumonia, but resistance may be an aggravating factor. Antibiotics may not be required for treatment in mild cases due to the self-resolving nature of M. pneumonia infection, regardless of macrolide resistance. In contrast, antibiotic treatment of severe cases of M. pneumoniae pneumonia is complicated. The clinical benefit of tetracyclines and fluoroquinolones has been shown in terms of shortening duration of symptoms and rapid defervescence in some reports. However, due to safety concerns regarding these two alternative antibiotics, clinicians should weigh the risks and benefits when choosing treatment options. Alternative antibiotics may be considered when patients remain febrile or when chest x-rays show deterioration at least 48-72 hours after macrolide treatment.

Authors+Show Affiliations

a Department of Pediatrics , Seoul National University College of Medicine , Seoul , South Korea. b Department of Pediatrics , Seoul National University Bundang Hospital , Seongnam , South Korea.a Department of Pediatrics , Seoul National University College of Medicine , Seoul , South Korea. c Department of Pediatrics , Seoul National University Children's Hospital , Seoul , South Korea.a Department of Pediatrics , Seoul National University College of Medicine , Seoul , South Korea. c Department of Pediatrics , Seoul National University Children's Hospital , Seoul , South Korea.a Department of Pediatrics , Seoul National University College of Medicine , Seoul , South Korea. c Department of Pediatrics , Seoul National University Children's Hospital , Seoul , South Korea.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

29212389

Citation

Lee, Hyunju, et al. "Antimicrobial Therapy of Macrolide-resistant Mycoplasma Pneumoniae Pneumonia in Children." Expert Review of Anti-infective Therapy, vol. 16, no. 1, 2018, pp. 23-34.
Lee H, Yun KW, Lee HJ, et al. Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Expert Rev Anti Infect Ther. 2018;16(1):23-34.
Lee, H., Yun, K. W., Lee, H. J., & Choi, E. H. (2018). Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Expert Review of Anti-infective Therapy, 16(1), 23-34. https://doi.org/10.1080/14787210.2018.1414599
Lee H, et al. Antimicrobial Therapy of Macrolide-resistant Mycoplasma Pneumoniae Pneumonia in Children. Expert Rev Anti Infect Ther. 2018;16(1):23-34. PubMed PMID: 29212389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. AU - Lee,Hyunju, AU - Yun,Ki Wook, AU - Lee,Hoan Jong, AU - Choi,Eun Hwa, Y1 - 2017/12/11/ PY - 2017/12/8/pubmed PY - 2018/10/3/medline PY - 2017/12/8/entrez KW - Drug resistance KW - Mycoplasma pneumoniae KW - children KW - macrolides KW - pneumonia SP - 23 EP - 34 JF - Expert review of anti-infective therapy JO - Expert Rev Anti Infect Ther VL - 16 IS - 1 N2 - INTRODUCTION: Mycoplasma pneumoniae is an important cause of community-acquired pneumonia in children and young adolescents. Macrolides are recommended as the first-line therapy however, macrolide resistance rates in M. pneumoniae among children have been increasing substantially. Areas covered: This review focused on clinical characteristics and treatment of macrolide-resistant M. pneumoniae pneumonia in children. Expert commentary: Antibiotic choice should be based on in vitro activity, clinical efficacy and in consideration of potential adverse events. Macrolide resistance did not contribute to the clinical severity of M. pneumoniae pneumonia, but resistance may be an aggravating factor. Antibiotics may not be required for treatment in mild cases due to the self-resolving nature of M. pneumonia infection, regardless of macrolide resistance. In contrast, antibiotic treatment of severe cases of M. pneumoniae pneumonia is complicated. The clinical benefit of tetracyclines and fluoroquinolones has been shown in terms of shortening duration of symptoms and rapid defervescence in some reports. However, due to safety concerns regarding these two alternative antibiotics, clinicians should weigh the risks and benefits when choosing treatment options. Alternative antibiotics may be considered when patients remain febrile or when chest x-rays show deterioration at least 48-72 hours after macrolide treatment. SN - 1744-8336 UR - https://www.unboundmedicine.com/medline/citation/29212389/Antimicrobial_therapy_of_macrolide_resistant_Mycoplasma_pneumoniae_pneumonia_in_children_ L2 - https://www.tandfonline.com/doi/full/10.1080/14787210.2018.1414599 DB - PRIME DP - Unbound Medicine ER -