Doxycycline for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children: Clinical Updates and Therapeutic Insights Post-COVID-19
Abstract
Rongjie Chen,1,2 Zhe Xu1 1Department of Pediatrics, Guangyuan Central Hospital, Lizhou District, Guangyuan, Sichuan Province, 628000, People’s Republic of China; 2Department of Pediatrics, Guangyuan Central Hospital Affiliated to North Sichuan Medical College, Shunqing District, Nanchong City, Sichuan Province, 637000, People’s Republic of ChinaCorrespondence: Zhe Xu, Department of Pediatrics, Guangyuan Central Hospital, Guangyuan, Sichuan, 628000, People’s Republic of China, Email [email protected]: Mycoplasma pneumoniae (MP) is a leading cause of community-acquired pneumonia (CAP) in children. Macrolides have long been first-line therapy due to favorable safety profiles and low minimum inhibitory concentrations (MICs) in pediatric populations. However, the global surge in macrolide-resistant MP (MRMP) has compromised conventional treatments, creating an urgent need for alternative agents. Mounting evidence supports doxycycline, a second-generation tetracycline, as an effective therapy for pediatric MRMP, particularly post-COVID-19. Compared to azithromycin, doxycycline shortens disease duration, accelerates the resolution of fever and cough, promotes pulmonary infiltrate absorption, and yields robust outcomes in children ≥ 8 years old. It also reduces corticosteroid use and exhibits a favorable safety profile. For refractory MP pneumonia (RMPP), combination therapy with doxycycline and corticosteroids (eg, methylprednisolone) enhances therapeutic effects. Ongoing…
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