Bin Cao1,2, Jiu-Xin Qu1, Yu-Dong Yin1, Johan Van Eldere3. 1. Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China. 2. Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China. 3. Department of Microbiology, UZ Leuven, Leuven, Belgium.
Abstract
BACKGROUND AND AIMS: Community-acquired pneumonia (CAP) is a common infectious disease affecting children and adults of any age. Mycoplasma pneumoniae has emerged as leading causative agent of CAP in some region, and the abrupt increasing resistance to macrolide that widely used for management of M. pneumoniae has reached to the level that it often leads to treatment failures. OBJECTIVE: We aim to discuss the drivers for development of macrolide-resistant M. pneumoniae, antimicrobial stewardship and also the potential treatment options for patients infected with macrolide-resistant M. pneumonia. METHODS: The articles in English and Chinese published in Pubmed and in Asian medical journals were selected for the review. RESULTS: M. pneumoniae can develop macrolide resistance by point mutations in the 23S rRNA gene. Inappropriate and overuse of macrolides for respiratory tract infections may induce the resistance rapidly. A number of countries have introduced the stewardship program for restricting the use of macrolide. Tetracyclines and fluoroquinolones are highly effective for macrolide-resistant strains, which may be the substitute in the region of high prevalence of macrolide-resistant M. pneumoniae. CONCLUSION: The problem of macrolide resistant M. pneumonia is emerging. Antibiotic stewardship is needed to inhibit the inappropriate use of macrolide and new antibiotics with a more acceptable safety profile for all ages need to be explored.
BACKGROUND AND AIMS: Community-acquired pneumonia (CAP) is a common infectious disease affecting children and adults of any age. Mycoplasma pneumoniae has emerged as leading causative agent of CAP in some region, and the abrupt increasing resistance to macrolide that widely used for management of M. pneumoniae has reached to the level that it often leads to treatment failures. OBJECTIVE: We aim to discuss the drivers for development of macrolide-resistant M. pneumoniae, antimicrobial stewardship and also the potential treatment options for patients infected with macrolide-resistant M. pneumonia. METHODS: The articles in English and Chinese published in Pubmed and in Asian medical journals were selected for the review. RESULTS:M. pneumoniae can develop macrolide resistance by point mutations in the 23S rRNA gene. Inappropriate and overuse of macrolides for respiratory tract infections may induce the resistance rapidly. A number of countries have introduced the stewardship program for restricting the use of macrolide. Tetracyclines and fluoroquinolones are highly effective for macrolide-resistant strains, which may be the substitute in the region of high prevalence of macrolide-resistant M. pneumoniae. CONCLUSION: The problem of macrolide resistant M. pneumonia is emerging. Antibiotic stewardship is needed to inhibit the inappropriate use of macrolide and new antibiotics with a more acceptable safety profile for all ages need to be explored.
Authors: Daniela Loconsole; Anna Lisa De Robertis; Rosanna Mallamaci; Anna Sallustio; Anna Morea; Rosa Prato; Michele Quarto; Domenico Martinelli; Maria Chironna Journal: Biomed Res Int Date: 2019-03-17 Impact factor: 3.411
Authors: Thaís Cristina Vilela Rodrigues; Arun Kumar Jaiswal; Alissa de Sarom; Letícia de Castro Oliveira; Carlo José Freire Oliveira; Preetam Ghosh; Sandeep Tiwari; Fábio Malcher Miranda; Leandro de Jesus Benevides; Vasco Ariston de Carvalho Azevedo; Siomar de Castro Soares Journal: R Soc Open Sci Date: 2019-07-31 Impact factor: 2.963