Caeleigh Smith, Karin Ng, Kendra Sih, Alastair Mcalpine, Ran D Goldman
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Question: A 5-year-old child was seen in our clinic with a clinical presentation consistent with community-acquired pneumonia. She was prescribed a course of amoxicillin and azithromycin, but remained febrile and returned to the clinic 3 days later. The family just returned from a trip to Japan. What is the current available evidence for treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia?
Answer: Macrolide-resistant M pneumoniae (MRMP) rates are increasing worldwide, with especially high prevalence in China, Japan, and Taiwan. Most evidence in children supports the use of tetracyclines for MRMP with more limited evidence supporting fluoroquinolones for this indication. Children with M pneumoniae pneumonia and a history of recent travel to countries with high rates of resistance or who do not improve within 48 to 72 hours of macrolide treatment should be treated with 2 mg/kg of doxycycline orally twice daily (maximum 100 mg per dose).
期刊介绍:
Mission: Canadian Family Physician (CFP), a peer-reviewed medical journal, is the official publication of the College of Family Physicians of Canada. Our mission is to ensure that practitioners, researchers, educators and policy makers are informed on current issues and in touch with the latest thinking in the discipline of family medicine; to serve family physicians in all types of practice in every part of Canada in both official languages; to advance the continuing development of family medicine as a discipline; and to contribute to the ongoing improvement of patient care.