Risk factors and prescription patterns analysis for macrolide-resistant Mycoplasma pneumoniae pneumonia in children.

First-line macrolide therapy is encountering challenges due to the escalating incidence of macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMPP). This study aimed to illustrate prescription patterns among children diagnosed with either macrolide-sensitive Mycoplasma pneumoniae pneumonia (MSMPP) or MRMPP and to further analyze the risk factors associated with MRMPP. This research encompassed 825 children who were diagnosed with Mycoplasma pneumoniae pneumonia (MPP) at a tertiary hospital located in central China in 2023. Notably, the MRMPP group had a longer fever duration compared to the MSMPP group. A combination of doxycycline and piperacillin-tazobactam was the most frequently used treatment for hospitalized MRMPP children, whereas azithromycin was the primary choice for the MSMPP group. More children in the MRMPP group required discharge medications, primarily doxycycline, whereas the MSMPP group primarily received azithromycin. Furthermore, a history of allergy emerged as an increased risk factor for MRMPP, alongside age, fever, pulmonary imaging changes, and co-detections of bacteria or fungi.