{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:23:42Z","timestamp":1785432222420,"version":"3.56.0"},"reference-count":22,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The prevalence of macrolide-resistant\n                      <jats:italic toggle=\"yes\">Mycoplasma pneumoniae<\/jats:italic>\n                      in Japan is increasing once again. This study compared the therapeutic efficacy of fluoroquinolone lascufloxacin with minocycline, the recommended first-choice drug for patients with macrolide-resistant\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia. A prospective observational study was conducted at 12 facilities affiliated with Kansai Medical University Hospital, investigating patients with\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia between January 2024 and January 2025. Of the 93 patients with\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia, 51 (54%) were found to be infected with macrolide-resistant\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      . All of these patients had an A-to-G transition at position 2063 in domain V of the 23S rRNA gene, resulting in high-level resistance to macrolides. Of the 33 patients with macrolide-sensitive\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia, 91% and 90% of patients experienced defervescence within 48 hours of initiating antibiotics with lascufloxacin and minocycline, respectively. Among the 42 patients with macrolide-resistant\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia, 90% of those in the lascufloxacin group and 90% of those in the minocycline group experienced defervescence within 48 hours of starting antibiotics. No antibiotic changes were recorded for patients in either group. Our results demonstrate that lascufloxacin may be an effective treatment for macrolide-resistant\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia, even in highly resistant strains. Physicians may consider using lascufloxacin or minocycline instead of macrolides when macrolide-resistant\n                      <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                      pneumonia is suspected and defervescence does not occur within 48 hours of starting macrolide treatment.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        Since the isolation of macrolide-resistant\n                        <jats:italic toggle=\"yes\">Mycoplasma pneumoniae<\/jats:italic>\n                        in 2000, resistant strains have spread rapidly across East Asia. In Japan, the prevalence rate of macrolide-resistant\n                        <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                        has decreased since peaking in 2012. Nevertheless, 80\u2013100% of\n                        <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                        strains in East Asia have become macrolide-resistant. Consequently, it was predicted that the number of macrolide-resistant strains would rise again in Japan. The Japanese Society of Mycoplasmology, therefore, recommended minocycline as the antibiotic of choice for treating macrolide-resistant\n                        <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                        pneumonia. Drug susceptibility to\n                        <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                        differs among respiratory quinolones, and the clinical efficacy of tosufloxacin, which has a high minimum inhibitory concentration, is inferior. Therefore, differences in efficacy may exist among respiratory quinolones. In this study, we investigated the therapeutic efficacy of lascufloxacin in patients with macrolide-resistant\n                        <jats:italic toggle=\"yes\">M. pneumoniae<\/jats:italic>\n                        pneumonia, confirming that it was equally effective as minocycline.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.00255-25","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T08:32:33Z","timestamp":1750235553000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic efficacy of lascufloxacin in patients with\n                    <i>Mycoplasma pneumoniae<\/i>\n                    pneumonia"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3730-4908","authenticated-orcid":true,"given":"Naoyuki","family":"Miyashita","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001xjdh50","id-type":"ROR","asserted-by":"publisher"}],"name":"First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University","place":["Hirakata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ogata","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001xjdh50","id-type":"ROR","asserted-by":"publisher"}],"name":"First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University","place":["Hirakata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Fukuda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001xjdh50","id-type":"ROR","asserted-by":"publisher"}],"name":"First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University","place":["Hirakata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihisa","family":"Yamura","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001xjdh50","id-type":"ROR","asserted-by":"publisher"}],"name":"First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University","place":["Hirakata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Ito","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/001xjdh50","id-type":"ROR","asserted-by":"publisher"}],"name":"First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University","place":["Hirakata, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00120-17"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2023.04.008"},{"key":"e_1_3_4_4_2","first-page":"255","article-title":"Phase III double-blind comparative study of intravenous lascufloxacin and levofloxacin in patients with community-acquired pneumonia","volume":"69","author":"Miki M","year":"2021","unstructured":"Miki M, Mikasa K, Kadota J, Mukae H, Fujita J, Yanagihara K, Tateda K, Totsuka K, Umemoto Y, Tanioka S, Kohno S. 2021. Phase III double-blind comparative study of intravenous lascufloxacin and levofloxacin in patients with community-acquired pneumonia. Jpn J Chemother 69:255\u2013269.","journal-title":"Jpn J Chemother"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00048-13"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00737-13"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2011.02102.x"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2006.00937_12.x"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis784"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.2.709-712.2006"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-009-0715-7"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348-0421.2001.tb01293.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.12.4624-4630.2004"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01684-08"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1086\/653535"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00385"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001365"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2020.10.007"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1202357"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2022.01.002"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12866-024-03180-0"},{"key":"e_1_3_4_22_2","volume-title":"Guiding principles for treating Mycoplasma pneumoniae pneumonia","author":"The Committee of Japanese Society of Mycoplasmology","year":"2014","unstructured":"The Committee of Japanese Society of Mycoplasmology. 2014. Guiding principles for treating Mycoplasma pneumoniae pneumonia. The Japanese Society of Mycoplasmology."},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.65.535"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00255-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00255-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:05:24Z","timestamp":1754399124000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.00255-25"}},"subtitle":[],"editor":[{"given":"Monica","family":"Cartelle Gestal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,5]]}},"alternative-id":["10.1128\/spectrum.00255-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.00255-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"2025-01-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00255-25"}}