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Risk factors and prescription patterns analysis for macrolide-resistant Mycoplasma pneumoniae pneumonia in children

Yun Lu1, Wen-Jing Li1, Xuan-Xuan Wang1

  • 1Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China.

Iscience
|January 6, 2025
PubMed

Insights

Macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMPP) is rising, challenging standard treatments. This study reveals distinct prescription patterns and identifies allergy history as a key risk factor for MRMPP in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Medicine
  • Antimicrobial Resistance

Background:

  • First-line macrolide therapy for Mycoplasma pneumoniae pneumonia (MPP) faces increasing resistance.
  • Macrolide-resistant MPP (MRMPP) presents a growing clinical challenge, particularly in pediatric populations.
  • Understanding treatment patterns and risk factors for MRMPP is crucial for effective management.

Purpose of the Study:

  • To delineate antibiotic prescription patterns for pediatric patients with macrolide-sensitive MPP (MSMPP) versus MRMPP.
  • To identify and analyze risk factors associated with the development of MRMPP in children.
  • To inform clinical practice regarding the treatment of pediatric MPP.

Main Methods:

  • Retrospective analysis of 825 pediatric MPP cases diagnosed in 2023 at a central Chinese tertiary hospital.
  • Comparison of clinical characteristics, treatment regimens (including inpatient and discharge medications), and outcomes between MSMPP and MRMPP groups.
  • Statistical analysis to identify risk factors for MRMPP, including demographic, clinical, and microbiological data.

Main Results:

  • The MRMPP group exhibited longer fever duration compared to the MSMPP group.
  • Doxycycline and piperacillin-tazobactam combination was the primary inpatient treatment for MRMPP, while azithromycin was favored for MSMPP.
  • Doxycycline was the predominant discharge medication for MRMPP patients, contrasting with azithromycin for MSMPP patients.

Conclusions:

  • Treatment strategies for pediatric MRMPP differ significantly from those for MSMPP, often involving non-macrolide agents like doxycycline.
  • History of allergy, advanced age, prolonged fever, pulmonary imaging abnormalities, and co-infections with bacteria or fungi are identified as significant risk factors for MRMPP.
  • These findings highlight the need for updated clinical guidelines to address the rising challenge of macrolide resistance in pediatric MPP.
Keywords:
health sciencesmedicinepharmaceutical science

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