Clinical Efficacy of Doxycycline for Treatment of Macrolide-Resistant Pneumonia in Children

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2021 Mar 6

PMID 33671151

Citations 13

Authors

Hyunju Lee

Youn Young Choi

Young Joo Sohn

Ye Kyung Kim

Mi Seon Han

Ki Wook Yun

Kyungmin Kim

Ji Young Park

Jae Hong Choi

Eun Young Cho

Eun Hwa Choi

Affiliations

Soon will be listed here.

Abstract

In areas with high prevalence of macrolide-resistant (MRMP) pneumonia, treatment in children has become challenging. This study aimed to analyze the efficacy of macrolides and doxycycline with regard to the presence of macrolide resistance. We analyzed children with MP pneumonia during the two recent epidemics of 2014-2015 and 2019-2020 from four hospitals in Korea. Nasopharyngeal samples were obtained from children with pneumonia for MP cultures and polymerase chain reaction (PCR). Macrolide resistance was determined by the analysis of 23S rRNA gene transition. Time to defervescence and to chest X-ray improvement were analyzed. Of 145 cases, the median age was 5.0 years and MRMP accounted for 59 (40.7%). Among macrolide-susceptible MP (MSMP), 78 (90.7%) were treated with macrolides and 21 (35.6%) in the MRMP group with doxycycline. In MRMP pneumonia, shorter days to defervescence (2 vs. 5 days, < 0.001) and to chest X-ray improvement (3 vs. 6 days, < 0.001) in the doxycycline group than in the macrolide group was observed, whereas no differences were observed among children with MSMP pneumonia. Compared to macrolides, treatment with doxycycline resulted in better outcomes with a shorter time to defervescence and to chest X-ray improvement among children with MRMP pneumonia.

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