Effect of Early Oral Administration of Doxycycline on Macrolide Resistance in Children with Mycoplasma Pneumoniae Pneumonia: A Retrospective Study

Abstract

Aims/Background Mycoplasma pneumoniae pneumonia (MPP) is typically a benign and self-limiting disease. This study aimed to investigate the effect of early oral administration of doxycycline on macrolide resistance in children with MPP. Methods This study retrospectively analyzed the clinical data of 173 MPP children treated with macrolides at the Second Affiliated Hospital of Mudanjiang Medical University from March 2020 to March 2023. Nine cases that did not meet the inclusion criteria were excluded, leaving 164 children. They were divided into Group A (early oral administration of doxycycline + macrolide treatment) (n = 85) and Group B (macrolide treatment alone) (n = 79) based on whether early oral administration of doxycycline was given. Drug sensitivity results and adverse reactions after treatment were statistically analyzed. Based on the drug sensitivity results, the MPP children were classified as having either macrolide-resistant mycoplasma pneumoniae (MRMP) or macrolide-sensitive mycoplasma pneumoniae (MSMP) infections. A stratified analysis was performed to compare the disappearance time of fever, disappearance time of shortness of breath, disappearance time of rales, and symptom improvement time on chest X-ray examination, and to further explore the clinical efficacy of early oral administration of doxycycline in different groups of children. Results No significant differences were found in baseline data such as age, sex, and weight between the two groups (p > 0.05). A total of 112 out of 164 children developed macrolide resistance (68.29%), with 47 cases in Group A and 65 cases in Group B, indicating a significant difference between the two groups (p < 0.05). The two groups showed a significant difference in macrolide sensitivity levels after treatment (p < 0.05), with no significant difference in the incidence of adverse reactions (p > 0.05). After treatment, the time to the disappearance of febrile fever, time to disappearance time of fever, disappearance time of shortness of breath, disappearance time of rales, symptom improvement time on chest X-ray examination, and time to administration of macrolides after treatment were shorter in children with MRMP in group A than in children with MRMP in group B (p < 0.05). In contrast, MSMP children in both groups exhibited no significant differences in symptom disappearance time and duration of macrolides treatment (p > 0.05). Conclusion Early oral administration of doxycycline is a safe and effective treatment for MPP. It helps relieve symptoms in MRMP children, shortens the duration of macrolide use, and reduces the incidence of macrolide resistance.

Keywords: children; doxycycline; drug resistance; macrolides; mycoplasma; pneumonia.