One of the first documented pediatric patients with adult respiratory
distress syndrome who had macrolide-resistant pneumonia holds some important
lessons for clinicians, according to results of a study published online
Yu-Chia Hsieh, MD, PhD, of the department of pediatrics, Chang
Gung Children’s Hospital in Taoyuan, Taiwan, and colleagues said the
patient — a 6-year-old girl — developed the symptoms around the same
time as her 7-year-old brother. Both children had cough and rhinorrhea, and
chest radiography taken at the time of hospital admission revealed opacity on
the children’s lobes, as well as prolonged fever.
The researchers said macrolide-resistant Mycoplasma pneumoniae
has been on the rise in Japan, China and some European countries in recent
years, making effective antimicrobial treatment a paramount consideration,
“In the siblings, high fever persisted and clinical deterioration
developed, even after macrolide therapy. We observed that clinical conditions
in the two cases improved after
doxycycline treatment,” the researchers wrote in
They said there were several limitations of the data, including that
they could not completely exclude concomitant infection in the siblings and
that no extensive immunologic workup was done for the siblings to study whether
there was host-related factors that could explain their disease severity.
Regardless, the researchers concluded, “Our cases warrant more
studies on the prevalence of macrolide-resistant M. pneumoniae and to
evaluate the optimal treatment in severe cases of macrolide-resistant M.
Disclosure: The researchers report no relevant financial