BACKGROUND AND OBJECTIVE: Children with community-acquired lower respiratory tract infection (CA-LRTI) commonly receive antibiotics for Mycoplasma pneumoniae. The objective was to evaluate the effect of treating M. pneumoniae in children with CA-LRTI. METHODS: PubMed, Cochrane Central Register of Controlled Trials, and bibliography review. A search was conducted by using Medical Subject Headings terms related to CA-LRTI and M. pneumoniae and was not restricted by language. Eligible studies included randomized controlled trials (RCTs) and observational studies of children #17 years old with confirmed M. pneumoniae and a diagnosis of CA-LRTI; each must have also compared treatment regimens with and without spectrum of activity against M. pneumoniae. Data extraction and quality assessment were completed independently by multiple reviewers before arriving at a consensus. Data were pooled using a random effects model. RESULTS: Sixteen articles detailing 17 studies were included. The most commonly selected primary outcome was symptomatic improvement. Nine studies examined M. pneumoniae treatment in CA-LRTI secondary to M. pneumoniae, and 5 RCTs met criteria for meta-analysis. The suggested pooled risk difference of 0.12 (95% confidence interval, 20.04 to 0.20) favoring treatment was not significantly different and demonstrated significant heterogeneity. Limitations included substantial bias and subjective outcomes within the individual studies, difficulty interpreting testing modalities, and the inability to correct for mixed infections or timing of intervention. CONCLUSIONS: We identified insufficient evidence to support or refute treatment of M. pneumoniae in CA-LRTI. These data highlight the need for well-designed, prospective RCTs assessing the effect of treating M. pneumoniae in CA-LRTI.
BACKGROUND AND OBJECTIVE:Children with community-acquired lower respiratory tract infection (CA-LRTI) commonly receive antibiotics for Mycoplasma pneumoniae. The objective was to evaluate the effect of treating M. pneumoniae in children with CA-LRTI. METHODS: PubMed, Cochrane Central Register of Controlled Trials, and bibliography review. A search was conducted by using Medical Subject Headings terms related to CA-LRTI and M. pneumoniae and was not restricted by language. Eligible studies included randomized controlled trials (RCTs) and observational studies of children #17 years old with confirmed M. pneumoniae and a diagnosis of CA-LRTI; each must have also compared treatment regimens with and without spectrum of activity against M. pneumoniae. Data extraction and quality assessment were completed independently by multiple reviewers before arriving at a consensus. Data were pooled using a random effects model. RESULTS: Sixteen articles detailing 17 studies were included. The most commonly selected primary outcome was symptomatic improvement. Nine studies examined M. pneumoniae treatment in CA-LRTI secondary to M. pneumoniae, and 5 RCTs met criteria for meta-analysis. The suggested pooled risk difference of 0.12 (95% confidence interval, 20.04 to 0.20) favoring treatment was not significantly different and demonstrated significant heterogeneity. Limitations included substantial bias and subjective outcomes within the individual studies, difficulty interpreting testing modalities, and the inability to correct for mixed infections or timing of intervention. CONCLUSIONS: We identified insufficient evidence to support or refute treatment of M. pneumoniae in CA-LRTI. These data highlight the need for well-designed, prospective RCTs assessing the effect of treating M. pneumoniae in CA-LRTI.
Authors: Preeta K Kutty; Seema Jain; Thomas H Taylor; Anna M Bramley; Maureen H Diaz; Krow Ampofo; Sandra R Arnold; Derek J Williams; Kathryn M Edwards; Jonathan A McCullers; Andrew T Pavia; Jonas M Winchell; Stephanie J Schrag; Lauri A Hicks Journal: Clin Infect Dis Date: 2019-01-01 Impact factor: 9.079
Authors: Matthew J Lipshaw; Michelle Eckerle; Todd A Florin; Eric J Crotty; Jessi Lipscomb; Judd Jacobs; Mantosh S Rattan; Richard M Ruddy; Samir S Shah; Lilliam Ambroggio Journal: Pediatrics Date: 2020-03-16 Impact factor: 7.124
Authors: Patrick M Meyer Sauteur; Selina Krautter; Lilliam Ambroggio; Michelle Seiler; Paolo Paioni; Christa Relly; Riccarda Capaul; Christian Kellenberger; Thorsten Haas; Claudine Gysin; Lucas M Bachmann; Annemarie M C van Rossum; Christoph Berger Journal: Clin Infect Dis Date: 2020-10-23 Impact factor: 9.079
Authors: Jesús López-Alcalde; Ricardo Rodriguez-Barrientos; Jesús Redondo-Sánchez; Javier Muñoz-Gutiérrez; José María Molero García; Carmen Rodríguez-Fernández; Julio Heras-Mosteiro; Jaime Marin-Cañada; Jose Casanova-Colominas; Amaya Azcoaga-Lorenzo; Virginia Hernandez Santiago; Manuel Gómez-García Journal: Cochrane Database Syst Rev Date: 2018-09-06