Tetracycline trumps macrolide in MRMP pneumonia

Tetracycline demonstrates superior clinical efficacy to that of macrolide in children with macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia, a study has shown.

The authors systematically searched for comparative studies examining the clinical outcomes of macrolide and tetracycline antibiotics in children with MRMP pneumonia. They performed a meta-analysis of the mean duration of fever, hospital stay duration, therapeutic efficacies, and time to defervescence to compare the two therapies.

Eleven studies involving 1,143 patients in China, Japan, and Korea met the eligibility criteria. These studies analysed the outcomes of febrile days, hospital stay duration, therapeutic efficacy, and time to defervescence. The macrolides examined were azithromycin and clarithromycin, while tetracyclines included minocycline and doxycycline.

In pooled estimates of five studies, the mean duration of febrile days (weighted mean difference, 1.64 days, 95 percent confidence interval [CI], 0.68‒2.59) and hospital stay (weighted mean difference, 1.22 days, 95 percent CI, 0.82‒1.62) was longer in patients treated with macrolide versus tetracycline.

Furthermore, tetracycline exhibited significantly higher therapeutic efficacy than macrolide (odds ratio, 0.33, 95 percent CI, 0.20‒0.57).

Further research is warranted to confirm these findings and inform evidence-based clinical practice guidelines, according to the authors.

“The global prevalence of MRMP pneumonia infections, particularly in children, is on the rise,” they said. “It is imperative to assess the clinical efficacies of alternative antibiotics such as tetracyclines to ensure effective treatment, mitigate antibiotic resistance, enhance clinical outcomes, and minimize the spread of resistant strains among MRMP-infected children.”