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Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early

Hye Young Han1,2, Ki Cheol Park3, Eun-Ae Yang1,2

  • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea.

Journal of Clinical Medicine
|April 3, 2021
PubMed

Insights

Early corticosteroid therapy effectively reduced morbidity in children with pneumonia caused by Mycoplasma pneumoniae. Treatment outcomes were similar for both macrolide-resistant and sensitive strains, though higher doses may be needed for persistent fever.

Area of Science:

  • Pediatric infectious diseases
  • Respiratory medicine
  • Microbiology

Background:

  • Pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae) is a common childhood illness.
  • Macrolide resistance in M. pneumoniae is increasing globally.
  • Corticosteroid therapy has shown potential in managing severe M. pneumoniae pneumonia.

Purpose of the Study:

  • To evaluate the efficacy of early corticosteroid therapy in children with M. pneumoniae pneumonia.
  • To compare outcomes between macrolide-resistant and macrolide-sensitive M. pneumoniae infections.
  • To identify factors associated with treatment response.

Main Methods:

  • Retrospective analysis of 56 children treated with early corticosteroids for M. pneumoniae pneumonia (July 2019-February 2020).
  • Diagnosis confirmed by PCR and serological tests.
  • Genetic analysis identified point mutations (A2063G) in the 23S rRNA gene of macrolide-resistant strains.

Main Results:

  • Early corticosteroid treatment was effective in reducing morbidity.
  • No significant differences in clinical or laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups.
  • 73% of subjects had macrolide-resistant M. pneumoniae, with the A2063G transition being the predominant mutation.

Conclusions:

  • Early corticosteroid therapy is effective for M. pneumoniae pneumonia, regardless of macrolide resistance.
  • Higher corticosteroid doses may be necessary for patients with persistent fever or elevated biomarkers.
  • Further research is needed to optimize steroid dosing strategies.
Keywords:
Mycoplasma pneumoniaechildcorticosteroidmacrolidepneumonia

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