Effectiveness of Early Doxycycline Intervention in Treating Macrolide‐Resistant <i>Mycoplasma pneumoniae</i> Pneumonia in Pediatric Patients

Background Mycoplasma pneumoniae pneumonia, primarily caused by Mycoplasma pneumoniae , poses a significant burden on pediatric respiratory health, with macrolide‐resistant strains complicating treatment. With macrolide resistance on the rise, alternative treatment options are imperative. Doxycycline has emerged as a promising alternative due to its broad‐spectrum efficacy and favorable safety profile. However, the clinical scenarios for its administration, particularly in macrolide‐resistant Mycoplasma pneumoniae pneumonia in children, have not been extensively explored. Methods Clinical data of 129 pediatric patients with macrolide‐resistant Mycoplasma pneumoniae pneumonia were retrospectively analyzed. Drug sensitivity testing was performed for one group to confirm the absence of doxycycline resistance, while the other group switched to doxycycline after unsatisfactory effects of macrolide therapy. Clinical response, laboratory parameters, treatment‐emergent adverse events, and cytokine levels were compared between the groups. Results The group that switched to doxycycline after drug sensitivity testing had notably shorter fever resolution time (3.65 ± 1.24 vs. 3.06 ± 1.15 days), cough relief time (4.82 ± 1.45 vs. 4.13 ± 1.36 days), and a higher chest X‐ray improvement percentage (80.15 ± 5.48% vs. 81.95 ± 4.52%) compared to the unsatisfactory curative effect group. Baseline laboratory parameters, treatment‐emergent adverse events, and baseline cytokine levels showed no significant differences. However, posttreatment, significant differences were observed in IL‐8 (42.16 ± 7.89 vs. 38.83 ± 7.61 pg/mL), IL‐10 (19.35 ± 3.21 vs. 18.14 ± 3.37 pg/mL), and SAA (31.14 ± 5.67 vs. 29.26 ± 3.22 mg/L) between the two groups. Conclusion Early doxycycline use, particularly after drug sensitivity testing, demonstrated potential clinical efficacy in the treatment of macrolide‐resistant Mycoplasma pneumoniae pneumonia in children.