Clinical Care of Mycoplasma pneumoniae Infection

Key points

  • Most Mycoplasma pneumoniae infections are self-limiting.
  • Healthcare providers routinely treat pneumonia caused by M. pneumoniae with antibiotics.
  • Some strains of M. pneumoniae may be resistant to macrolides.
A bottle of antibiotics and common items to measure out a liquid medication.

Treatment options

Healthcare providers can treat M. pneumoniae infections with the following classes of antibiotics:

  • Macrolides
  • Tetracycline
  • Fluoroquinolones

Beta-lactam antibiotics don't work on mycoplasmas‎

All mycoplasmas lack a cell wall and, therefore, are inherently resistant to beta-lactam antibiotics (e.g., penicillin).

Treatment recommendations

Take the age of the patient and local antibiotic resistance patterns into consideration.

Macrolides
  • Children and adults
Tetracyclines
  • Older children and adults
Fluoroquinolones
  • Adults

Healthcare providers shouldn't prescribe tetracyclines and fluoroquinolones for young children under normal circumstances. Macrolides are generally considered the treatment of choice.

However, consider using a second-line antibiotic regimen to treat patients with suspected or confirmed M. pneumoniae infection who aren't improving on macrolides. Consider potential adverse effects in children and pregnant people when using fluoroquinolones or tetracyclines.

Promote the judicious use of antibiotics and minimize the risk of antibiotic resistance by not prescribing antibiotics unless indicated by clinical or laboratory evidence.

Antibiotic resistance

Resistance to macrolides emerged in M. pneumoniae in the early 2000s. There is global variability, but it has remained under 10% in United States.

Print
Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases