Effects of minocycline on macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children: a single-center retrospective study
Year: 2021
Type: article
Study design: Observational Study
Abstract: 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.
Source: Translational Pediatrics
DOI: 10.21037/tp-21-356
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Award: G425253163
OpenAlex ID: W3195280957