Posicionamiento de la Sociedad Española de Infectología Pediátrica sobre el diagnóstico y tratamiento de la infección por Mycoplasma pneumoniae
- Walter Alfredo Goycochea-Valdivia
- Josefa Ares Alvarez
- Antonio José Conejo Fernández
- Ana Belén Jiménez Jiménez
- Irene Maté Cano
- Teresa de Jesús Reinoso Lozano
- Carlos Rodrigo Gonzalo de Liria
ISSN: 1695-4033, 1696-4608
Ano de publicación: 2024
Volume: 101
Número: 1
Páxinas: 46-57
Tipo: Artigo
Outras publicacións en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumo
Mycoplasma pneumoniae (MP) is a bacterium with particular characteristics that give rise to a broad clinical spectrum, and respiratory infection is the most frequent presentation. Infection by MP occurs in cyclical epidemics, and paediatricians in Spain have noticed an increase in cases since January 2024, establishing hospital registers to collect surveillance data (as it is not a notifiable disease in Spain). The diagnosis of infection by MP is made through serological testing and/or the detection of genetic material by means of polymerase chain reaction (PCR). Neither methods can differentiate between colonization and active infection, so a precise diagnosis is not possible and testing should only be requested in the case of high clinical suspicion. The role of antibiotherapy in infection by MP in its different clinical variants is not well defined. Most infections are self-limiting and mild, and there is insufficient evidence to support the use of antibiotherapy in these cases. Antibiotic treatment is justified in patients with risk factors for the development of severe disease (Down syndrome, anatomical or functional asplenia, immunosuppression), in hospitalized patients with respiratory infection and in patients with moderate or severe extrapulmonary forms. Taking into account aspects concerning the rational use of antimicrobials, the treatment of choice would be clarithromycin, with azithromycin as an alternative, reserving the use of doxycycline and levofloxacin for cases of antimicrobial resistance and/or infections of the central nervous system.