[Case of macrolide-ineffective Mycoplasma pneumoniae pneumonia successfully treated with intravenous ciprofloxacin].

A 18-year-old man complaining of remittent fever and nonproductive cough visited a nearby clinic. He did not recover despite treatment of oral azithromycin. We admitted him because his chest radiograph showed consolidation in the left upper lung field. We diagnosed his pneumonia as co-infection by non-bacterial and bacterial pathogens, and initiated treatment with intravenous ampicillin and oral clarithromycin. On the 3rd day after admission his symptom had not improved, so his treatment was changed to intravenous panipenem/betamipron and erythromycin. Ciprofloxacin was administered intravenously because consolidative shadows with atelectasis increased on the chest radiograph on the 6th day. Clinical symptoms such as fever, CRP and chest radiograph findings were rapidly improved after the start of ciprofloxacin treatment. He was discharged on the 22nd hospital day. Since serum antibody titer against Mycoplasma pneumoniae was elevated to x 20,480 on the 13th hospital day, it is confirmed that causative pathogen was macrolide-ineffective Mycoplasma Pneumoniae.