title: Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae.
abstract: Macrolide-resistant Mycoplasma pneumoniae (MR M. pneumoniae) has been isolated from clinical specimens in Japan since 2000. A comparative study was carried out to determine whether or not macrolides are effective in treating patients infected with MR M. pneumoniae. The clinical courses of 11 patients with MR M. pneumoniae infection (MR patients) treated with macrolides were compared with those of 26 patients with macrolide-susceptible M. pneumoniae infection (MS patients). The total febrile days and the number of febrile days during macrolide administration were longer in the MR patients than in the MS patients (median of 8 days versus median of 5 days [P = 0.019] and 3 days versus 1 day [P = 0.002], respectively). In addition, the MR patients were more likely than the MS patients to have had a change of the initially prescribed macrolide to another antimicrobial agent (63.6% versus 3.8%; odds ratio, 43.8; P < 0.001), which might reflect the pediatrician's judgment that the initially prescribed macrolide was not sufficiently effective in these patients. Despite the fact that the febrile period was prolonged in MR patients given macrolides, the fever resolved even when the initial prescription was not changed. These results show that macrolides are certainly less effective in MR patients.
authors.affiliation: Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Satowa
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Narita
authors.forename: Norio
authors.initials: N
authors.lastname: Okazaki
authors.forename: Isao
authors.initials: I
authors.lastname: Suzuki
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Andoh
authors.forename: Mayumi
authors.initials: M
authors.lastname: Matsuoka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kenri
authors.forename: Yoshichika
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Tsuguo
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000494:pharmacology*; D008297:Male; D009177:Mycoplasma pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides