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

• Authors: Jiande Chen, Xinyi Qi, Yong Yin, Lei Zhang, Jing Zhang, Shuhua Yuan
• Journal: Translational pediatrics (Transl Pediatr) Vol. 10 Issue 11 Pg. 2997-3004 (Nov 2021) ISSN: 2224-4344 [Print] China
• PMID: 34976765 (Publication Type: Journal Article)
• Copyright: 2021 Translational Pediatrics. All rights reserved.