Comparative clinical response, safety, and institutional drug use efficiency of intravenous azithromycin versus erythromycin in pediatric Mycoplasma pneumoniae pneumonia: a real-world evidence study

IV AZI and IV ERY showed comparable overall clinical response in hospitalized pediatric MPP. The age interaction is a response-heterogeneity signal requiring confirmation, not causal proof of efficacy reversal. ERY carried higher odds of mostly mild adverse events, longer duration, and greater institutional macrolide cost burden. These results support future work on resistance-informed, sequence-aware, and child-appropriate formulation stewardship to improve interpretability, safety precision, and institutional antibiotic sustainability.