title: Macrolide therapy and outcomes in a multicenter cohort of children hospitalized with Mycoplasma pneumoniae pneumonia.
abstract: BACKGROUND
  Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in childhood. Few studies have addressed the association of antimicrobial treatment and outcomes.
  
  
  OBJECTIVE
  To determine whether macrolide therapy is associated with improved outcomes among children hospitalized with M. pneumoniae pneumonia.
  
  
  METHODS
  Multicenter retrospective cohort study.
  
  
  METHODS
  Thirty-six children's hospitals which contribute data to the Pediatric Health Information System.
  
  
  METHODS
  Children 6-18 years of age discharged with a diagnosis of M. pneumoniae pneumonia.
  
  
  METHODS
  Initial macrolide therapy.
  
  
  METHODS
  Length of stay (LOS), all-cause readmissions, and asthma-related hospitalizations.
  
  
  RESULTS
  Empiric macrolide therapy was administered to 405 (58.7%) of 690 patients. The median LOS was 3 days (interquartile range, 2-6 days). Eight (1.2 %) patients were readmitted within 28 days, and 160 (23.2%) were readmitted within 15 months of index discharge. Ninety-five (13.7%) patients were hospitalized for asthma within 15 months of index discharge. Empiric macrolide therapy was associated with a 32% shorter overall LOS (adjusted beta-coefficient, -0.38; 95% confidence interval [CI]: -0.59 to -0.17). Macrolide therapy was not associated with all-cause readmission at 28 days (adjusted odds ratio, 1.12; 95% CI: 0.22-5.78) or 15 months (adjusted odds ratio, 1.00; 95% CI: 0.59-1.70) or with asthma-related hospitalizations at 15 months (adjusted odds ratio, 0.85; 95% CI: 0.36-1.97).
  
  
  CONCLUSIONS
  In this large multicenter study of children hospitalized with M. pneumoniae pneumonia, empiric macrolide therapy was associated with a shorter hospital LOS. Macrolide therapy was not associated with 28-day or 15-month hospital readmission.
authors.affiliation: Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Samir.shah@cchmc.org
authors.forename: Samir S
authors.initials: SS
authors.lastname: Shah
authors.forename: Matthew
authors.initials: M
authors.lastname: Test
authors.forename: Seth
authors.initials: S
authors.lastname: Sheffler-Collins
authors.forename: Anna K
authors.initials: AK
authors.lastname: Weiss
authors.forename: Matthew
authors.initials: M
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D009177:Mycoplasma pneumoniae; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018942:Macrolides