Effects of minocycline on macrolide-unresponsive pneumonia in children: a single-center retrospective study.

BACKGROUND

Macrolide-resistant () has become widespread in the world. We sought to determine the independently associated risk factors for refractory pneumonia among macrolide-unresponsive pneumonia children treated with minocycline and to investigate the effects of minocycline against macrolide-unresponsive pneumonia.

METHODS

In our center, we retrospectively analyzed the data of hospitalized macrolide-unresponsive pneumonia patients aged ≤18 years old who changed macrolide therapies to minocycline treatments between March 2013 and September 2018. Patient characteristics and defervescence after minocycline treatment were compared between refractory pneumonia and non-refractory pneumonia groups. Multivariable logistic regression analysis was performed among these macrolide-unresponsive pneumonia patients.

RESULTS

Among 150 included macrolide-unresponsive pneumonia children treated with minocycline; 30 cases (20.0%) were refractory pneumonia. Duration of macrolide treatment before administration of minocycline (odds ratio =2.87, 95% CI: 1.79-4.61, P<0.001) and serum procalcitonin levels (odds ratio =13.50, 95% CI: 1.22-149.57, P=0.034) were independently associated with refractory pneumonia. Defervescence after minocycline treatment was significantly longer among the refractory pneumonia group than in the non-refractory pneumonia group (median 2 1 day, P<0.001). Only one case (0.7%) suspected of a side effect of minocycline therapy was observed.

CONCLUSIONS

Two risk factors independently associated with refractory pneumonia were determined. Early use of minocycline might safely prevent macrolide-unresponsive pneumonia from progressing to refractory pneumonia.