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, healthcare providers should practice prudent use of macrolide drugs due to the emergence of macrolide-resistant strains of M. pneumoniae.

Antibiotic resistance

Resistance to macrolides emerged in M. pneumoniae in the early 2000s. There is global variability, but it's remained under 15% in United States.

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