{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:47:58Z","timestamp":1788414478243,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health and Welfare","award":["HI16C2300"],"award-info":[{"award-number":["HI16C2300"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725\/4159) of patients, with asthma being the most common (n = 334\/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides.<\/jats:p>","DOI":"10.3390\/jcm11020306","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T20:29:26Z","timestamp":1641760166000},"page":"306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Yun Jung","family":"Choi","sequence":"first","affiliation":[{"name":"Hospital Medicine Center, Seoul National University Hospital, Seoul KS013, Korea"},{"name":"Department of Pediatrics, Seoul National University Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-0151","authenticated-orcid":false,"given":"Eun Hee","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon KS015, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju KS018, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul-Hong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon KS011, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0796-2558","authenticated-orcid":false,"given":"Yong Ju","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yongin Severance Hospital, Yongin KS009, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Bin","family":"Kim","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong-Seong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ulsan University Gangneung Asan Hospital, Gangneung KS007, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pusan National University Children\u2019s Hospital, Yangsan KS011, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoojung","family":"Cho","sequence":"additional","affiliation":[{"name":"SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Hee","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan KS002, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Suk","family":"Sol","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myongsoon","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi KS010, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0647-3186","authenticated-orcid":false,"given":"Dae Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Eulji General Hospital, Eulju University, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hea Lin","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Korea Cancer Center Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinho","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungsu","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pusan National University Children\u2019s Hospital, Yangsan KS011, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Suk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Suk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon KS011, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwang Cheon","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Goyang KS007, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0151-9758","authenticated-orcid":false,"given":"Yoon-Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu KS002, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai Lee","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu KS002, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Min","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dongguk University Gyeongju Hospital, Gyeongju KS010, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9077-5779","authenticated-orcid":false,"given":"Man Yong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam KS009, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Yeon","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Tack","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7287-4300","authenticated-orcid":false,"given":"Hyeon-Jong","family":"Yang","sequence":"additional","affiliation":[{"name":"SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul KS013, Korea"},{"name":"Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-8728","authenticated-orcid":false,"given":"Dong In","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul National University Hospital, Seoul KS013, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1128\/CMR.17.4.697-728.2004","article-title":"Mycoplasma pneumoniae and its role as a human pathogen","volume":"17","author":"Waites","year":"2004","journal-title":"Clin. 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Infect."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/2\/306\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:27:04Z","timestamp":1760362024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/2\/306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,8]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jcm11020306"],"URL":"https:\/\/doi.org\/10.3390\/jcm11020306","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,8]]}}}