Mycoplasma pneumoniae: a pathogen with unsolved therapeutic problems.

INTRODUCTION

Despite the amount of new information, the most effective approach for the diagnosis and treatment of infections is not established. In this narrative review the pharmacological options for macrolide-resistant (ML) infections in children are discussed.

AREAS COVERED

Despite significant improvement in the diagnosis and in the definition of diseases potentially associated with this pathogen, not all the problems related to infection are solved. True epidemiology of diseases and the real role of this pathogen in extra-respiratory manifestations is still unestablished. This reflects on therapy. It is not known whether antibiotics are really needed in all the cases, independently of severity and localization. The choice of antibiotic therapy is debated as it is not known whether ML resistance has clinical relevance. Moreover, not precisely defined is the clinical importance of corticosteroids for improvement of severe cases, including those associated with ML-resistant strains.

EXPERT OPINION

Improvement in identification is mandatory to reduce antibiotics overuse , especially in the presence of ML-resistant strains. Priority for future studies includes the evaluation of the true benefit of therapeutic approaches including corticosteroids in patients with severe CAP and in those with extra-respiratory diseases.