Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children

Ha, Seok Gyun; Oh, Kyung Jin; Ko, Kwang-Pil; Sun, Yong Han; Ryoo, Eell; Tchah, Hann; Jeon, In Sang; Kim, Hyo Jeong; Ahn, Jung Min; Cho, Hye-Kyung

In this study, the prevalence of macrolide-unresponsive MP pneumonia was 16.3%, which was much lower than the prevalence of MRMP reported in Korea (87.2% in 2015) . 14 This discrepancy between macrolide-resistance and macrolide-unresponsiveness indicated that most patients with MRMP pneumonia achieved defervescence within 72 hours after macrolide administration. Matsubara et al. 19 demonstrated that 22.7% of MRMP cases showed clinical improvement within 3 days after macrolide treatment. In addition, Suzuki et al. 17 reported that fever resolved with the initially prescribed macrolide, without changing antibiotics, for the treatment of MRMP infection, and there was no apparent treatment failure or cases of serious illness. It was suggested that macrolides have anti-inflammatory effects, as well as antimicrobial effects, through the inhibition of the production of cytokines such as IL-6 and IL-8 in human bronchial epithelial cells. 29, 30 In our data, there were no cases of treatment failure in the PMC group, except for two cases of re-hospitalization. In these two cases, defervescence occurred within 24 hours without a change in antibiotics after rehospitalization.