title: Characteristics of hospitalized children infected with macrolide-resistant Mycoplasma pneumoniae.
abstract: BACKGROUND
  The aim of this study was to clarify retrospectively the characteristics of children hospitalized for respiratory tract infection caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae).
  
  
  METHODS
  Children who were hospitalized for respiratory tract infection due to M. pneumoniae were enrolled in this study. The diagnosis of M. pneumoniae infection was made on the grounds of polymerase chain reaction results.
  
  
  RESULTS
  Thirty-three children were hospitalized due to lower respiratory tract infection with M. pneumoniae. Of the 33 children, 31 (median age five years) were identified as being infected with macrolide-resistant M. pneumoniae (A2063G:30, A2064G:1) by sequence analysis. Of the 31 children infected with macrolide-resistant M. pneumoniae, 21 (68%) had received 14- or 15-membered macrolide antibiotics and four (13%) had received minocycline before hospitalization. During hospitalization, minocycline was administered to 16 (52%) of the 31 children infected with macrolide-resistant M. pneumoniae. Of the 20 children infected with macrolide-resistant M. pneumoniae under eight years of age, six (30%) were treated with minocycline during hospitalization. The difference in total febrile days between children receiving minocycline treatment before hospitalization and children not receiving minocycline treatment was three days.
  
  
  CONCLUSIONS
  The majority of hospitalized children with respiratory tract infection due to macrolide-resistant M. pneumoniae infection was of preschool age and had received 14- or 15-membered macrolide antibiotics before hospitalization. Because macrolide-resistant M. pneumoniae is widespread in Japan, the administration of minocycline as a second-line antibiotic in children under eight years of age cannot be withheld when clinical symptoms do not improve with macrolide antibiotics.
authors.affiliation: Department of Pediatrics, Toho University Sakura Medical Center, Japan; Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan. Electronic address: haruki-komatsu@chive.ocn.ne.jp.
authors.forename: Haruki
authors.initials: H
authors.lastname: Komatsu
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsunoda
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Inui
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sogo
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Fujisawa
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D018942:Macrolides; D008297:Male; D009177:Mycoplasma pneumoniae / Q000235:genetics*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000188:drug therapy*; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides
keywords: Antibiotics; Minocycline; Mutation; Young children