Research Progress in Mechanisms of Drug-Resistance of Macrolide Antibiotics Resistance in Mycoplasma pneumoniae

Aim/Background This review aims to enhance understanding of Mycoplasma pneumoniae (MP) infection and Macrolide-Resistant Mycoplasma pneumoniae (MRMP) pneumonia, emphasizing their epidemiological characteristics and resistance mechanisms. MP is a major cause of Community-Acquired Pneumonia (CAP) in children, with potential extra-pulmonary manifestations. The objective is to guide early diagnosis and timely treatment, addressing the challenges posed by MP’s resistance to β-Lactam and vancomycin drugs. Materials and Methods The review examines the current status of macrolide antibiotics, such as erythromycin, azithromycin, clarithromycin, josamycin, and roxithromycin, highlighting their mechanisms of action and interference with microbial protein synthesis. It also explores laboratory testing methods for identifying MRMP and assessing resistance mechanisms. Results The review synthesizes knowledge on MRMP infection characteristics and epidemiology, highlighting the global increase in MRMP cases, which limits treatment options for pediatric patients. It discusses resistance mechanisms and the urgent need for effective clinical treatments due to rising macrolide resistance. Conclusion This review underscores the critical need for a deeper understanding of MP infection and the alarming rise of macrolide resistance. It emphasizes judicious use of macrolide antibiotics and advocates for ongoing research to develop alternative treatment strategies. The findings highlight the necessity for enhanced surveillance, accurate laboratory testing methods, and updated clinical guidelines to manage MRMP pneumonia effectively, particularly in the pediatric population.