Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

Ishiguro Nobuhisa; Koseki Naoko; Kaiho Miki; Ariga Tadashi; Kikuta Hideaki; Togashi Takehiro; Oba Koji; Morita Keisuke; Nagano Naoko; Nakanishi Masanori; Hara Kazuya; Hazama Kyosuke; Watanabe Toru; Yamanaka Tatsuru; Sasaki Satoshi; Furuyama Hideto; Shibata Mutsuo; Shida Satoru; Ishizaka Akihito; Tabata Yuichi; Aoyagi Hayato; Naito Hiroyuki; Yoshioka Mikio; Horino Atsuko; Kenri Tsuyoshi; Hokkaido Pediatric Respiratory Infection Study Group

Title	en Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients
Creator	en Ishiguro, Nobuhisa NRID 1000040168216 en Koseki, Naoko en Kaiho, Miki en Ariga, Tadashi NRID 1000060322806 en Kikuta, Hideaki en Togashi, Takehiro en Oba, Koji NRID 1000030422926 en Morita, Keisuke en Nagano, Naoko en Nakanishi, Masanori en Hara, Kazuya en Hazama, Kyosuke en Watanabe, Toru en Yamanaka, Tatsuru en Sasaki, Satoshi en Furuyama, Hideto en Shibata, Mutsuo en Shida, Satoru en Ishizaka, Akihito en Tabata, Yuichi en Aoyagi, Hayato en Naito, Hiroyuki en Yoshioka, Mikio en Horino, Atsuko en Kenri, Tsuyoshi en Hokkaido Pediatric Respiratory Infection Study Group
Accessrights	open access
Rights	https://creativecommons.org/licenses/by/4.0/ en Creative Commons Attribution 4.0 International
Subject	NDC 490
Description	Abstract en Objective: To clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients. Methods: A prospective, multicenter observational study was conducted from July 2013 to August 2015. The therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin were evaluated in 59 patients with pneumonia caused by MRMP and in 50 patients with pneumonia caused by MSMP. In vitro activities of antimicrobial agents against isolates of Mycoplasma pneumoniae were also measured. Results: Mean durations of fever following commencement of treatment in patients infected with MRMP and MSMP were 5.2 and 1.9 days, respectively (log-rank test, P < 0.0001). Among patients infected with MRMP, mean durations of fever were 4.6, 5.5, 1.0 and 7.5 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P < 0.0001). Among patients infected with MSMP, mean durations of fever were 2.5, 1.7, 0.9 and 4.3 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P = 0.0162). The MIC90s of azithromycin and clarithromycin among the 27 isolates of MRMP were 64 and 256 μg/ml, respectively, and those among the 23 isolates of MSMP were <0.000125 and 0.001 μg/ml, respectively. The MIC90s of minocycline and tosufloxacin among the 27 isolates of MRMP were 1.0 and 0.25 μg/ml, respectively, and those among the 23 isolates of MSMP were 1.0 and 0.5 μg/ml, respectively. Conclusion: Both minocycline and tosufloxacin showed good in vitro activities against MRMP. Minocycline, but not tosufloxacin, shortened the duration of fever in pediatric patients infected with MRMP compared to the duration of fever in patients treated with macrolides.
Publisher	en The Public Library of Science
Date	Issued2017-03-13
Language	eng
Resource Type	journal article
Version Type	VoR
Identifier	HDL http://hdl.handle.net/2115/65654
Relation	isIdenticalTo DOI https://doi.org/10.1371/journal.pone.0173635
Journal	PISSN 1932-6203 en PLoS ONE Volume Number12 Issue Number3 Page Starte0173635
File	fulltext journal.pone.0173635.pdf 909.71 KB (application/pdf) Issued2017-03-13
Oaidate	2023-07-26