{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:55:42Z","timestamp":1791568542566,"version":"4.3.4"},"reference-count":72,"publisher":"Korean Pediatric Society","issue":"12","license":[{"start":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T00:00:00Z","timestamp":1591747200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:p>The major pathogens that cause atypical pneumonia are &lt;i&gt;Mycoplasma pneumoniae, Chlamydophila pneumoniae&lt;\/i&gt;, and &lt;i&gt;Legionella pneumophila&lt;\/i&gt;. Community-acquired pneumonia (CAP) caused by &lt;i&gt;M. pneumoniae&lt;\/i&gt; or &lt;i&gt;C. pneumoniae&lt;\/i&gt; is common in children and presents as a relatively mild and self-limiting disease. CAP due to &lt;i&gt;L. pneumophila&lt;\/i&gt; is very rare in children and progresses rapidly, with fatal outcomes if not treated early. &lt;i&gt;M. pneumoniae, C. pneumoniae&lt;\/i&gt;, and &lt;i&gt;L. pneumophila&lt;\/i&gt; have no cell walls; therefore, they do not respond to \u03b2-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant &lt;i&gt;M. pneumoniae&lt;\/i&gt; that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant &lt;i&gt;M. pneumoniae&lt;\/i&gt; pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without &lt;i&gt;M. pneumoniae&lt;\/i&gt; epidemics, may not provide additional benefits over \u03b2-lactam monotherapy and can increase the risk of MRMP. <\/jats:p>","DOI":"10.3345\/cep.2019.00360","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T05:35:47Z","timestamp":1591767347000},"page":"469-476","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Current perspectives on atypical pneumonia in children"],"prefix":"10.3345","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-2233","authenticated-orcid":true,"given":"Jung Yeon","family":"Shim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2016.11.011"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.5582\/bst.2016.01021"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000048"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2010.01924.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.10326"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1086\/523003"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2017.60.6.167"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3201\/eid2310.170106"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2015.07.018"},{"key":"ref10","volume-title":"2017 Guidelines for the antibiotic use in children with lower respiratory tract infections [Internet]","year":"2017"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00800"},{"key":"ref12","volume-title":"Infectious disease portal. 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