Characteristics of hospitalized children infected with macrolide-resistant Mycoplasma pneumoniae

Komatsu, Haruki; Tsunoda, Tomoyuki; Inui, Ayano; Sogo, Tsuyoshi; Fujisawa, Tomoo

doi:10.1016/j.bjid.2013.09.004

Cited by 12 publications

(9 citation statements)

References 31 publications

(43 reference statements)

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“…Minocycline is well known to be effective for treatment of MRMP infection in pediatric patients aged more than 8 years [14, 23, 26]. The clinical effects of tosufloxacin in patients infected with MRMP have been controversial.…”

Section: Discussionmentioning

confidence: 99%

“…In patients infected with MRMP, the duration of fever following commencement of treatment with minocycline was significantly shorter than the duration of fever following commencement of treatment with macrolides (azithromycin and clarithromycin) and tosufloxacin ( Fig 1 , Table 3 ). Minocycline is well known to be effective for treatment of MRMP infection in pediatric patients aged more than 8 years [ 14 , 23 , 26 ]. The clinical effects of tosufloxacin in patients infected with MRMP have been controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Minocycline and fluoroquinolones were shown to be more effective than macrolides in adult patients infected with MRMP [ 22 ]. Minocycline and tosufloxacin have also been used for treatment of pediatric patients infected with MRMP [ 14 , 23 – 26 ]. Tetracyclines including minocycline are incorporated into teeth, cartilage and bone, resulting in discoloration of both primary and permanent dentitions [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

et al. 2017

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ObjectiveTo clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients.MethodsA prospective, multicenter observational study was conducted from July 2013 to August 2015. The therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin were evaluated in 59 patients with pneumonia caused by MRMP and in 50 patients with pneumonia caused by MSMP. In vitro activities of antimicrobial agents against isolates of Mycoplasma pneumoniae were also measured.ResultsMean durations of fever following commencement of treatment in patients infected with MRMP and MSMP were 5.2 and 1.9 days, respectively (log-rank test, P < 0.0001). Among patients infected with MRMP, mean durations of fever were 4.6, 5.5, 1.0 and 7.5 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P < 0.0001). Among patients infected with MSMP, mean durations of fever were 2.5, 1.7, 0.9 and 4.3 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P = 0.0162). The MIC90s of azithromycin and clarithromycin among the 27 isolates of MRMP were 64 and 256 μg/ml, respectively, and those among the 23 isolates of MSMP were <0.000125 and 0.001 μg/ml, respectively. The MIC90s of minocycline and tosufloxacin among the 27 isolates of MRMP were 1.0 and 0.25 μg/ml, respectively, and those among the 23 isolates of MSMP were 1.0 and 0.5 μg/ml, respectively.ConclusionBoth minocycline and tosufloxacin showed good in vitro activities against MRMP. Minocycline, but not tosufloxacin, shortened the duration of fever in pediatric patients infected with MRMP compared to the duration of fever in patients treated with macrolides.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

et al. 2017

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“…It's well known that minocycline (tetracycline) is effective in the treatment of children with macrolideresistant Mp infection (7,8,11). In the Japanese guidelines for the management of respiratory infectious diseases in children, changing treatment to a tetracycline antibiotic has been recommended in possible macrolide-resistant Mp infection (12).…”

Section: Introductionmentioning

confidence: 99%

Effects of minocycline on macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children: a single-center retrospective study

Chen¹,

Qi²,

Yin³

et al. 2021

Transl Pediatr

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Background: Macrolide-resistant Mycoplasma pneumoniae (Mp) has become widespread in the world.We sought to determine the independently associated risk factors for refractory Mp pneumonia among macrolide-unresponsive Mp pneumonia children treated with minocycline and to investigate the effects of minocycline against macrolide-unresponsive Mp pneumonia. Methods: In our center, we retrospectively analyzed the data of hospitalized macrolide-unresponsive Mp pneumonia patients aged ≤18 years old who changed macrolide therapies to minocycline treatments between March 2013 and September 2018. Patient characteristics and defervescence after minocycline treatment were compared between refractory Mp pneumonia and non-refractory Mp pneumonia groups. Multivariable logistic regression analysis was performed among these macrolide-unresponsive Mp pneumonia patients. Results: Among 150 included macrolide-unresponsive Mp pneumonia children treated with minocycline; 30 cases (20.0%) were refractory Mp pneumonia. Duration of macrolide treatment before administration of minocycline (odds ratio =2.87, 95% CI: 1.79-4.61, P<0.001) and serum procalcitonin levels (odds ratio =13.50, 95% CI: 1.22-149.57, P=0.034) were independently associated with refractory Mp pneumonia. Defervescence after minocycline treatment was significantly longer among the refractory Mp pneumonia group than in the non-refractory Mp pneumonia group (median 2 vs. 1 day, P<0.001). Only one case (0.7%) suspected of a side effect of minocycline therapy was observed. Conclusions: Two risk factors independently associated with refractory Mp pneumonia were determined. Early use of minocycline might safely prevent macrolide-unresponsive Mp pneumonia from progressing to refractory Mp pneumonia.

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“…SMPP complications can lead to repeated infections and decreased quality of life for afflicted children. 2,3 The pathogenesis of SMPP likely involves many processes, such as excessive immune inflammatory reactions, mixed infections, and so on. Therefore, the abovementioned factors should be considered during SMPP treatment to reduce the development of pulmonary sequelae.…”

Section: Introductionmentioning

confidence: 99%

Bronchoscopic Features and Correlative Factor Analysis of Severe Mycoplasma pneumoniae Pneumonia in Children.

Yang¹,

G²,

Liu³

2021

Preprint

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Objectives: We aimed to determine the bronchoscopic features of children with severe Mycoplasma pneumoniae pneumonia (SMPP), and correlation with obliterative bronchitis (OB), so as to help early clinical evaluation and treatment of pediatric SMPP. Methods: 213 pediatric SMPP cases admitted to Beijing Children’s Hospital were included. Medical records and bronchoscopic manifestations at different SMPP stages were retrospectively analyzed . Results: Of 213 acute-stage pediatric SMPP patients, bronchoscopy revealed 22 cases (10.3%) with subacute-stage or recovery-stage OB, for an OB incidence rate in cases with mucous embolus of 48.8% (22/47), a significantly higher rate than the rate without mucous embolus (0/166, 0%) (P < 0.001). Notably, the OB incidence rate for children undergoing bronchoscopy within 10 days (9/142, 6.3%) of SMPP onset was significantly lower than in children undergoing bronchoscopy 10 days post-disease onset (13/71, 76.5%) (P < 0.007). Conclusions: In pediatric SMPP patients, airway mucus and debris from epithelial necrosis and exfoliation can block airway subbranches, readily leading to OB.

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Characteristics of hospitalized children infected with macrolide-resistant Mycoplasma pneumoniae

Cited by 12 publications

References 31 publications

Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

Effects of minocycline on macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children: a single-center retrospective study

Bronchoscopic Features and Correlative Factor Analysis of Severe Mycoplasma pneumoniae Pneumonia in Children.

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