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Comparison of Efficacy of Antimicrobial Agents Among Hospitalized Patients With Mycoplasma pneumoniae Pneumonia in Japan During Large Epidemics of Macrolide-Resistant M. pneumoniae Infections: A Nationwide Observational Study


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Title: Comparison of Efficacy of Antimicrobial Agents Among Hospitalized Patients With Mycoplasma pneumoniae Pneumonia in Japan During Large Epidemics of Macrolide-Resistant M. pneumoniae Infections: A Nationwide Observational Study
Authors: Tashiro, Masato / Fushimi, Kiyohide / Kawano, Kei / Takazono, Takahiro / Saijo, Tomomi / Yamamoto, Kazuko / Kurihara, Shintaro / Imamura, Yoshifumi / Miyazaki, Taiga / Yanagihara, Katsunori / Mukae, Hiroshi / Izumikawa, Koichi
Issue Date: 13-Nov-2017
Publisher: Oxford University Press
Citation: Clinical Infectious Diseases, 65(11), pp.1837-1842; 2017
Abstract: Background Mycoplasma pneumoniae strains with resistance to macrolides have been spreading worldwide. Here, we aimed to clarify which antimicrobial agent is a better treatment for patients with M. pneumoniae pneumonia in a setting with large epidemics of macrolide resistance. Methods Adult patients hospitalized with laboratory-confirmed M. pneumoniae pneumonia from 2010 to 2013 were identified from the Japanese Diagnosis Procedure Combination national database. Drug switching, length of stay (LOS), 30-day mortality, and total costs for patients who underwent macrolide, quinolone, and tetracycline therapy were compared using propensity score analyses. Results Eligible patients (N = 1650) from 602 hospitals were divided into the macrolide group (n = 508), quinolone group (n = 569), or tetracycline group (n = 573). We found that 52.8%, 21.8%, and 38.6% of patients in the macrolide, quinolone, and tetracycline groups, respectively, had to switch drugs (P <.0001). There was no significant difference in the LOS and the 30-day mortality rates among these 3 groups. Cost was highest in the quinolone group (P =.0062). The propensity score-matched pairs (n = 487×2) generated from the quinolone and tetracycline groups also showed a lower proportion of patients who require switches in the quinolone group than in the tetracycline group (21.2% vs 39.6%, P <.0001) but not in the LOS, mortality, and cost. Conclusions There were no significant differences in the LOS and mortality among any antimycoplasmal drugs as initial treatment for hospitalized M. pneumoniae pneumonia patients despite the lower switching rate in the quinolone group.
Keywords: antimicrobial agents / macrolide resistance / Mycoplasma pneumoniae / pneumonia
URI: http://hdl.handle.net/10069/38316
ISSN: 10584838
DOI: 10.1093/cid/cix695
Rights: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.  / This is a pre-copyedited, author-produced version of an article accepted for publication in Clinical Infectious Diseases following peer review. The version of record Clinical Infectious Diseases, 65(11), pp.1837-1842; 2017, is available online at: https://dx.doi.org/10.1093/cid/cix695
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/38316

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