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Antimicrobial Agents and Chemotherapy, February 2006, p. 709-712, Vol. 50, No. 2
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.2.709-712.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Clinical Evaluation of Macrolide-Resistant Mycoplasma pneumoniae

Satowa Suzuki,1 Tsutomu Yamazaki,2 Mitsuo Narita,3 Norio Okazaki,4 Isao Suzuki,5 Tomoaki Andoh,5 Mayumi Matsuoka,1 Tsuyoshi Kenri,1 Yoshichika Arakawa,1 and Tsuguo Sasaki1*

Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo,1 Department of Pediatrics, Saitama Medical School, Saitama,2 Sapporo Tetsudo Hospital, Hokkaido,3 Kanagawa Prefectural Institute of Public Health, Kanagawa,4 Department of Pediatrics, Chigasaki Municipal Hospital, Kanagawa, Japan5

Received 10 August 2005/ Returned for modification 24 October 2005/ Accepted 23 November 2005

Macrolide-resistant Mycoplasma pneumoniae (MR M. pneumoniae) has been isolated from clinical specimens in Japan since 2000. A comparative study was carried out to determine whether or not macrolides are effective in treating patients infected with MR M. pneumoniae. The clinical courses of 11 patients with MR M. pneumoniae infection (MR patients) treated with macrolides were compared with those of 26 patients with macrolide-susceptible M. pneumoniae infection (MS patients). The total febrile days and the number of febrile days during macrolide administration were longer in the MR patients than in the MS patients (median of 8 days versus median of 5 days [P = 0.019] and 3 days versus 1 day [P = 0.002], respectively). In addition, the MR patients were more likely than the MS patients to have had a change of the initially prescribed macrolide to another antimicrobial agent (63.6% versus 3.8%; odds ratio, 43.8; P < 0.001), which might reflect the pediatrician's judgment that the initially prescribed macrolide was not sufficiently effective in these patients. Despite the fact that the febrile period was prolonged in MR patients given macrolides, the fever resolved even when the initial prescription was not changed. These results show that macrolides are certainly less effective in MR patients.

* Corresponding author. Mailing address: Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan. Phone: (81) 425610771. Fax: (81) 425653315. E-mail: sasaki{at}nih.go.jp.

Antimicrobial Agents and Chemotherapy, February 2006, p. 709-712, Vol. 50, No. 2
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.2.709-712.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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