{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:43:43Z","timestamp":1787769823542,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To compare clinical and imaging features in children with macrolide\u2010susceptible (MSMP) and macrolide\u2010resistant\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      pneumonia (MRMP) in a real\u2010world clinical setting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analysed paediatric\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>M. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      (MP) cases at Hunan People's Hospital from June to December 2023, utilizing polymerase chain reaction (PCR) to categorize infections into MRMP and MSMP groups based on 23S rRNA mutations. We compared symptoms, laboratory findings, imaging results and treatment outcomes between MRMP and MSMP groups. Additionally, univariate and multivariate logistic regression analyses were performed to identify factors associated with the switch to doxycycline in MRMP patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 199 children with MP, 151 were categorized as MRMP due to 23S rRNA mutations, while 48 were classified as MSMP. The MRMP group included more preschool\u2010 and school\u2010aged children, with more severe symptoms (persistent high fever and extensive lung consolidation). MRMP patients received longer antibiotic courses, with imaging showing segmental or lobar infiltrates. Consequently, treatment was switched from azithromycin to doxycycline in 66.2% of MRMP patients. Multivariate logistic regression analysis revealed that segmental or lobar parenchymal infiltration was independently associated with an increased likelihood of receiving doxycycline (OR\u2009=\u20093.942,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These real\u2010world data suggest that MRMP may present with more severe clinical manifestations and radiological features than MSMP among hospitalized children during an atypical post\u2010COVID resurgence of MP. Doxycycline could be considered as the second\u2010line therapy for MRMP patients exhibiting severe symptoms or lung consolidation when macrolides fail to achieve clinical improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70336","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:16:17Z","timestamp":1772979377000},"page":"771-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Clinical Features and Treatment of\n                    <scp>\n                      <i>Mycoplasma pneumoniae<\/i>\n                    <\/scp>\n                    in Children With Macrolide\u2010Resistant and Macrolide\u2010Susceptible Infection"],"prefix":"10.1111","volume":"62","author":[{"given":"Yuan\u2010Ying","family":"Yu","sequence":"first","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Xie","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Luo","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Li","family":"Zhong","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian\u2010Hua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8763-1801","authenticated-orcid":false,"given":"Zi\u2010Jie","family":"Yuan","sequence":"additional","affiliation":[{"name":"Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)  Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir531"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00114-16"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2018.1414599"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-024-00831-0"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00344-0"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/d41586\u2010023\u201003732\u2010w"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00405-6"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2017.60.6.167"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S466994"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.12677\/ACM.2022.124449"},{"key":"e_1_2_14_12_1","volume-title":"Red Book: 2024\u20102027 Report of the Committee on Infectious Diseases. 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