title: Treatment of mycoplasma pneumonia: a systematic review.
abstract: OBJECTIVE
  Children with community-acquired lower respiratory tract infection (CA-LRTI) commonly receive antibiotics for Mycoplasma pneumoniae. The objective was to evaluate the effect of treating M. pneumoniae in children with CA-LRTI.
  
  
  METHODS
  PubMed, Cochrane Central Register of Controlled Trials, and bibliography review. A search was conducted by using Medical Subject Headings terms related to CA-LRTI and M. pneumoniae and was not restricted by language. Eligible studies included randomized controlled trials (RCTs) and observational studies of children #17 years old with confirmed M. pneumoniae and a diagnosis of CA-LRTI; each must have also compared treatment regimens with and without spectrum of activity against M. pneumoniae. Data extraction and quality assessment were completed independently by multiple reviewers before arriving at a consensus. Data were pooled using a random effects model.
  
  
  RESULTS
  Sixteen articles detailing 17 studies were included. The most commonly selected primary outcome was symptomatic improvement. Nine studies examined M. pneumoniae treatment in CA-LRTI secondary to M. pneumoniae, and 5 RCTs met criteria for meta-analysis. The suggested pooled risk difference of 0.12 (95% confidence interval, 20.04 to 0.20) favoring treatment was not significantly different and demonstrated significant heterogeneity. Limitations included substantial bias and subjective outcomes within the individual studies, difficulty interpreting testing modalities, and the inability to correct for mixed infections or timing of intervention.
  
  
  CONCLUSIONS
  We identified insufficient evidence to support or refute treatment of M. pneumoniae in CA-LRTI. These data highlight the need for well-designed, prospective RCTs assessing the effect of treating M. pneumoniae in CA-LRTI.
authors.forename: Eric
authors.initials: E
authors.lastname: Biondi
authors.forename: Russell
authors.initials: R
authors.lastname: McCulloh
authors.forename: Brian
authors.initials: B
authors.lastname: Alverson
authors.forename: Andrew
authors.initials: A
authors.lastname: Klein
authors.forename: Angela
authors.initials: A
authors.lastname: Dixon
authors.forename: Shawn
authors.initials: S
authors.lastname: Ralston
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D006801:Humans; D057970:Inappropriate Prescribing; D009177:Mycoplasma pneumoniae; D011014:Pneumonia / Q000188:drug therapy* / Q000209:etiology*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents