title: Mycoplasma pneumoniae infections--does treatment help?
abstract: Mycoplasma pneumoniae is a common cause of respiratory tract infections (RTI's), especially in children. While severe M. pneumoniae infections are generally treated with antibiotics, the diagnosis as well as treatment of these infections should be reconsidered in the light of recent clinical findings. First, M. pneumoniae was found to be carried in the upper respiratory tract of a relatively high percentage of healthy, asymptomatic children. Clearly, this complicates the diagnosis of a suspected M. pneumoniae RTI and, thus, the decision when to initiate treatment. A complication in the treatment of these infections is that data on the efficacy of antibiotic treatment of M. pneumoniae RTI's are sparse and derived exclusively from comparative studies. A recent Cochrane review concluded that there is insufficient evidence about the efficacy of antibiotics for M. pneumoniae lower respiratory tract infections (LRTI) in children. Due to side effects associated with the use of tetracyclines and quinolones in children, only macrolides can be used to treat M. pneumoniae infections in young patients. The general applicability of macrolides, however, is currently threatened by the worldwide increase in macrolide-resistant M. pneumoniae strains. Finally, limited evidence is available that corticosteroids might have an additional benefit in the treatment of M. pneumoniae infections. In this review, the current issues related to the diagnosis and treatment of M. pneumoniae infections will be discussed.
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases and Immunology, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: e.spuesens@erasmusmc.nl.
authors.forename: Emiel B M
authors.initials: EB
authors.lastname: Spuesens
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases and Immunology, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: p.meyersauteur@erasmusmc.nl.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Meyer Sauteur
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases and Immunology, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Erasmus University College, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: c.vink@erasmusmc.nl.
authors.forename: Cornelis
authors.initials: C
authors.lastname: Vink
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases and Immunology, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: a.vanrossum@erasmusmc.nl.
authors.forename: Annemarie M C
authors.initials: AM
authors.lastname: van Rossum
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006801:Humans; D009177:Mycoplasma pneumoniae / Q000502:physiology*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Asymptomatic carriage; Macrolide antibiotics; Mycoplasma pneumonia; Respiratory tract infections