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Research Article: Comparison of the therapeutic performance of macrolide antibiotics on macrolide-resistant or macrolide-susceptible Mycoplasma pneumoniae pneumonia children

Date Published: 2026-05-18

Abstract:
This research aims to investigate the performance of macrolide antibiotics for the treatment of Mycoplasma pneumoniae pneumonia (MPP) in children with or without Mycoplasma pneumoniae (MP) resistance genes. This retrospective study enrolled pediatric MPP patients admitted to the Department of Pediatrics at the hospital between January 2023 and December 2023. Macrolide resistance genes in MP were tested using throat swab and bronchoalveolar lavage fluid samples, and patients were classified into the macrolide-resistant MP (MRMP) group and the macrolide-susceptible MP (MSMP) group based on the results of v-domain point mutations. After sampling, all patients received standard macrolide treatment. The baseline characteristics and laboratory examination results were documented and compared. A total of 217 MPP patients were included, among these patients, 188 with v-domain point mutations (all A2063 G point mutation) were classified as MRMP (99 males, 5.84?±?2.81 years) with an MRMP rate of 86.6%, the remaining 29 were classified as MSMP (14 males, 6.79?±?4.08 years). No significant difference in baseline characteristics was observed between the patients of the two groups. While the MP DNA load was higher in both throat swabs (3.97?±?0.64 vs. 3.65?±?0.77; P =?0.039) and bronchoalveolar lavage fluid (4.11?±?0.58 vs. 3.18?±?0.77; P =?0.001) samples obtained from MRMP patients, the duration of macrolide therapy (7.66?±?1.95 vs. 6.38?±?2.37 days, P =?0.002) were also longer in MRMP patients. The incidence of severe Mycoplasma pneumoniae pneumonia (SMPP) was 5.8% in the MRMP group and 17.2% in the MSMP group ( P =?0.071). MP DNA load and the duration of macrolide use are higher in MRMP patients, while no significant difference was observed between the prevalence of adverse events and clinical characteristics after treatment, indicating that macrolide treatment demonstrates comparable clinical effectiveness in both MRMP and MSMP patients. However, the association between MP DNA load and duration of macrolide use should be further evaluated.

Introduction:
This research aims to investigate the performance of macrolide antibiotics for the treatment of Mycoplasma pneumoniae pneumonia (MPP) in children with or without Mycoplasma pneumoniae (MP) resistance genes.

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