Treatment of Mycoplasma pneumoniae in pediatric lower respiratory infection.

Abstract

* Abbreviations: CA — : community-acquired CAP — : community-acquired pneumonia LRI — : lower respiratory infection MP — : Mycoplasma pneumonia In this issue of Pediatrics , Biondi et al1 present a rigorous systematic review and meta-analysis of the literature on the use of antibiotics to treat community-acquired (CA) lower respiratory infections (LRIs) secondary to Mycoplasma pneumoniae (MP). Consistent with previous studies, but on a larger scale, the evidence is deemed insufficient to support or refute such treatments for MP. The following comments, although largely addressed in the article, are intended to highlight the caution that is required on the part of the reader when attempting to implement these conclusions to everyday practice. In particular, we must point out that lack of evidence of efficacy is not evidence of inefficacy when addressing current treatment paradigms. The problems of this and previous studies lie in the lack of uniformity of diagnostic methods, complicated by the fact that mixed infections with other microorganisms often go undiagnosed and contaminate any analysis of treatment efficacy. The small number of studies and their heterogeneity add to our inability to conclude either way, and therefore statements about results of MP-oriented antibiotic treatment are difficult … Address correspondence to Andrew A. Colin, MD, University of Miami Batchelor Children’s Institute, Pediatric Pulmonology, 1580 NW 10th Ave, First Floor (D-820), Miami, FL 33136. E-mail: acolin{at}med.miami.edu