Abstract
A high prevalence rate of macrolide-resistant Mycoplasma pneumoniae (MRMP) has been reported in Asia. We performed a systematic review and meta-analysis to investigate the effect of macrolide resistance on the manifestations and clinical judgment during M. pneumoniae infections. We found no difference in clinical severity between MRMP and macrolide-sensitive Mycoplasma pneumoniae (MSMP) infections. However, in the pooled data, patients infected with MRMP had a longer febrile period (1.71 days), length of hospital stay (1.61 day), antibiotic drug courses (2.93 days), and defervescence time after macrolide treatment (2.04 days) compared with patients infected with MSMP. The risk of fever lasting for >48 hours after macrolide treatment was also significantly increased (OR 21.24), and an increased proportion of patients was changed to second-line treatment (OR 4.42). Our findings indicate diagnostic and therapeutic challenges after the emergence of MRMP. More precise diagnostic tools and clearly defined treatment should be appraised in the future.
Highlights
A high prevalence rate of macrolide-resistant Mycoplasma pneumoniae (MRMP) has been reported in Asia
Laboratory Results We assessed inflammatory markers commonly examined during M. pneumoniae infection (Appendix Figure 3)
Eleven studies provided data on leukocyte count; we found no significant difference between MRMP and Mycoplasma pneumoniae (MSMP) patients (MD 0.09, 95% CI -0.31 to 0.50; p = 0.65)
Summary
A high prevalence rate of macrolide-resistant Mycoplasma pneumoniae (MRMP) has been reported in Asia. We performed a systematic review and meta-analysis to investigate the effect of macrolide resistance on the manifestations and clinical judgment during M. pneumoniae infections. We found no difference in clinical severity between MRMP and macrolide-sensitive Mycoplasma pneumoniae (MSMP) infections. Our findings indicate diagnostic and therapeutic challenges after the emergence of MRMP. During the past 10 years, macrolide-resistant Mycoplasma pneumoniae (MRMP) has emerged worldwide. 1 report showed more complications in managing MRMP infections [7], the association between severe disease and resistance remains inconsistent and unclear. We conducted a systematic review and meta-analysis to examine the effect of macrolide resistance on the manifestations, outcomes, and clinical judgment of M. pneumoniae infection
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