TY - JOUR T1 - Therapeutic efficacy of macrolides, minocycline and tosufloxacin against macrolide-resistant <em>Mycoplasma pneumoniae </em>pneumonia in pediatric patients JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4363 AU - Naoyuki Miyashita AU - Mika Kubo AU - Yasuhiro Kawai AU - Kazunobu Ouchi AU - Niro Okimoto Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4363.abstract N2 - Background and objective: Since 2000 the prevalence of macrolide-resistant (MR) Mycoplasma pneumoniae in pediatric patients has increased in Japan. The purpose of our study was to investigate differences in the clinical course, bacteriological effect and therapeutic efficacy against MR M. pneumoniae among macrolides, minocycline and tosufloxacin.Methods: We performed a multicenter prospective epidemiological study of MR M. pneumoniae for the first time. A total of 152 children with M. pneumoniae pneumonia confirmed by polymerase chain reaction (PCR) were analyzed. A search for mutations at sites 2063, 2064, and 2617 in the M. pneumoniae 23S rRNA domain V gene region was performed.Results: One hundred nine patients of 152 children with M. pneumoniae pneumonia were determined to have a MR gene. Fever disappeared within 48 hours after antibiotics administration in the MR patients was seen in 25% of the macrolides group, 83% in the minocycline group, and 81% in the tosufloxacin group. The DNA copy numbers in the MR patients showed little decrease after macrolide administration, but rapid decrease after administration of minocycline or tosufloxacin.Conclusions: The number of M. pneumoniae in the MR patients decreased promptly after 48 hours' minocyclne and tosufloxacin treatment and had a close relationship with clinical outcome. In contrast, we found that the clinical and bacteriological efficacy of macrolides for treating cases of MR patients was low. Our results might be indicate that minocycline and tosufloxacin considered as the first choice drugs for treatment of M. pneumoniae pneumonia in Japanese situation. ER -