Mycoplasma pneumonia is becoming a leading cause of community acquired pneumonia in children. Most cases are mild and self-limited. But, there are some cases of mycoplasma pneumonia that can cause severe respiratory distress and/or extrapulmonary symptoms such as mucositis, hepatitis, encephalitis, hemolysis, and erythema multiforme. Macrolides are the first line treatment for this disease, but due to widespread use, macrolide resistance is on the rise. This article is a systematic review and meta analysis which set out to look at the effect of macrolide resistance on the manifestations, outcomes, and clinical judgment of mycoplasma pneumonia infections.

24 articles were included in the meta analysis.

What they found was that clinical manifestations, radiographic findings, and laboratory data (leukocyte count, ESR, CRP) showed no significant differences between macrolide resistant mycoplasma pneumonia (MRMP) and macrolide sensitive mycoplasma pneumonia (MSMP) infections. Some studies suggested that there are more severe outcomes with MRMP, but overall the data did not support a causal link between macrolide resistance and disease severity. What they did acknowledge is that MRMP lends itself to a longer febrile disease course than MSMP. This is because macrolide efficacy was significantly reduced in MRMP cases due to mutations in some genes, leading to longer febrile durations post-treatment.

Due to macrolide resistance, more research should be done regarding other treatments for mycoplasma pneumonia (fluoroquinolone, tetracyclines).