The Treatment of Macrolide-Resistant Mycoplasma Pneumoniae Pneumonia in Children

Abstract Objective: To evaluate the efficacy and safety of levofloxacin in children with macrolide-resistant Mycoplasma pneumoniae pneumonia. Methods: We retrospectively enrolled six confirmed cases of refractory Mycoplasma pneumoniae pneumonia (n=6) who were admitted in the pediatric respiratory ward of Shandong provincial hospital Affiliated to Shandong first Medical University between January 1st, 2020and February 29th, 2020. Levofloxacin was given to the patients through the intravenous or oral route as per the following dosages :< 5 years, 8-10 mg/kg q12hours; > 5 years, 8-10 mg/kg, qd for ten days. The clinical data were collected and analyzed. Results: The average age of the enrolled cases was six years and nine months (range, four years, and seven months to eleven years and seven months). All cases were found to be drug-resistant and were treated with azithromycin combined with antibacterial drugs. Levofloxacin was used in the patient’s refractory to macrolide antibiotics. The temperature of five cases returned to normal 1 to 2 days after treatment with levofloxacin, and the imaging of the four cases showed expected improvements. The gastrointestinal symptoms, neurological manifestations, joint symptoms, blood parameters, liver and kidney functions, and exercise conditions of the children were closely monitored. The follow-up time of the patients ranged from one week to five months. No drug-related adverse reactions were observed in patients during treatment or during follow up.Conclusions: The clinical symptoms and imaging significantly improved after treatment with levofloxacin, and no drug-related adverse reactions were observed. Levofloxacin proved to be an effective and safe drug in the treatment of children with macrolide-resistant mycoplasma pneumonia.