Mycoplasma pneumoniae pneumoniae pneumonia (MPP) accounts for 10% to 40% of community-acquired pneumonia in children.
Macrolide antibiotics, as the preferred drug for MPP, have been prominently resistant in recent years. Macrolide resistant MP (MRMP) and refractory MPP (RMPP) are markedly increased, and some cases may develop severe Mycoplasma pneumoniae pneumoniae pneumonia (SMPP).
At this time, it is particularly important to master the use of antibacterial drugs other than azithromycin. The following is a table for you to sort out the relevant drug use methods:
First of all
Review of macrolide use in MPPs (table 1)
Table 1 (click for a larger view)
Azithromycin and erythromycin are preferred for oral administration, and intravenous routes are chosen after weighing the pros and cons of oral intolerable or severely infected children
In high-risk patients with congenital long QT syndrome, torsades de pointes, and bradyarrhythmias, azithromycin may increase the risk of death from arrhythmias
Choice of second-line alternatives
For mycoplasma pneumonia in children, various guidelines and expert consensus currently recommend macrolides as first-line drugs, and also point out that fluoroquinolones and tetracyclines can be used as second-line alternatives after failure of macrolide treatment.
●How to use quinolones (table 2)
Table 2 (click for a larger view)
●The use of tetracyclines is recommended for children over 8 years of age (table 3).
Table 3 (click for a larger view)
The above content, welcome to leave a message to discuss
Curated: Sunny days
Title image source: Stand Cool Helo
bibliography:
Yang Mei, Wang Xiaoling, Qian Suyun. Safety and efficacy of moxifloxacin in the treatment of severe Mycoplasma pneumoniae pneumonia in children[J]. Chinese Journal of Emergency Medicine. 2021, Vol. 30, No. 8.
[2] Chen J, Qi X, Yin Y, Zhang L, Zhang J, Yuan S. Effects of minocycline on macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children: a single-center retrospective study. Transl Pediatr. 2021 Nov;10(11):2997-3004. doi: 10.21037/tp-21-356. PMID: 34976765; PMCID: PMC8649588.
[3] Respiratory Group, Science Branch of Chinese Medical Association, Editorial Committee of Chinese Clinical Journal of Practical Pediatrics. Expert consensus on the diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children (2015 edition)[J]. Chinese Clinical Journal of Practical Pediatrics,2015,30(17):1304—1308.
National Health Commission, State Administration of Traditional Chinese Medicine. Specifications for the Diagnosis and Treatment of Community-Acquired PulmonaryItis in Children (2019 Edition)[J]. Chinese Journal of Clinical Infectious Diseases,2019,12(1):6—13.
Wu Junyan,Sun Shumei. Expert consensus on fluoroquinolone antimicrobials in children[J]. Pharmacy Today, 2018, 28(1):1-10.
[6] VelissariouIM.The use of fluoroquinolones in children: recent advances[J]. Expert Rev Anti Infect Ther, 2006, 4(5):853-860.
[7]van den OeverHL, VersteeghFG, ThewessenEA, et al. Ciprofloxacin in preterm neonates: case report and review of the literature[J]. Eur J Pediatr, 1998, 157(10):843-845.
[8] PrincipiN,EspositoS.Appropriate use of fluoroquinolones in children[J]. Int J Antimicrob Agents, 2015, 45(4):341-346.
Gao Hengmiao, Qian Suyun, Treatment of refractory, fulminant and macrolide-resistant Mycoplasma pneumoniae pneumonia[J]. China Journal of Pediatric Emergency Medicine, 2021,28(1): 1-6.