Analysis of the Efficacy of Azithromycin and Minocycline in the Treatment of Macrolide-Resistant and-Sensitive Mycoplasma Pneumoniae Pneumonia in Children
Objective To evaluate the efficacy of minocycline and azithromycin in the treatment of Mycoplasma pneumoniae pneumonia (MPP) and explore the related factors affecting therapeutic outcomes. Methods A total of 102 children diagnosed with MPP were recruited from the Department of Pediatrics,Beijing Daxing District People's Hospital,be-tween September 2023 and March 2024. Drug resistance was determined by nested PCR and DNA sequencing analysis of the 23S rRNA gene. Patients were divided into a drug-resistant group (n=52) and a drug-sensitive group (n=50). The correlation between fever duration,hospitalization status,antibiotic selection,and other factors was analyzed using the Cox proportional hazards model. Results The sensitive group demonstrated significantly shorter time to normal temperature,resolution of cough,and disappearance of pulmonary signs compared to the resistant group,with notable improvements in inflammatory markers (P<0.05). Among all patients,those treated with minocycline had a significantly shorter fever duration than those treated with azithromycin (hazard ratio=0.36,P=0.02). In the drug-resistant group,minocycline was significantly more effective than azithromycin (hazard ratio=0.04,P<0.001). In the sensitive group,the number of days from fever onset to administration was significantly associated with fever duration (hazard ratio=0.81,P=0.02). Conclusion Minocycline demonstrated superior efficacy in treating MPP,particularly in drug-resistant cases. These findings suggest that minocy-cline should be prioritized in children with macrolide resistance. Further large-scale,multi-center,and combination therapy studies are warranted to validate these results.
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