Antimicrobial Susceptibilities and Treatment Options for Pediatric Mycoplasma pneumoniae Infections - Does Macrolide Resistance Matter?
Ken B. Waites
Affiliation: Department of Pathology, University of Alabama at Birmingham, WP 230, 619 19th Street South, Birmingham, AL 35249, USA.
Mycoplasma pneumoniae is an important pathogen of the upper and lower respiratory tracts of children and
adults. Historically, it has been susceptible in vitro to macrolides, tetracyclines, and fluoroquinolones. Standardized methods
for performance and interpretation of in vitro susceptibility tests have now been published for M. pneumoniae and
mechanisms of acquired resistance to macrolides have been shown to be due to mutations in the 23S rRNA gene. Emergence
and widespread dissemination of clinically significant high-level macrolide resistance in Asia and documentation of
its occurrence to a lesser extent in several European countries and the United States during the past decade is worrisome
since treatment options for children are limited. This article summarizes the current status of antimicrobial susceptibility
testing, mechanisms of antimicrobial resistance, epidemiology of macrolide resistance and treatment alternatives for pediatric
infections caused by M. pneumoniae.
Keywords: Mycoplasma pneumoniae, antimicrobial susceptibility, treatment, antibiotic resistance, macrolide.
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