Mycoplasma Infections (Mycoplasma pneumoniae) Treatment & Management

Updated: Jul 24, 2017
  • Author: Ken B Waites, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Treatment

Medical Care

Ambulatory care versus hospitalization

The choice of outpatient management versus hospitalization for persons with community-acquired pneumonia depends on the clinical syndrome and not the organism, largely because the microbiologic diagnosis is often unavailable when the physician must make these decisions.

Professional organizations of physicians and managed care organizations have developed management algorithms that include decision trees for diagnostic studies and management, including specifications of antimicrobial agents to be used. These guidelines vary somewhat, but, in general, the decision to hospitalize a patient depends on an assessment of the following:

  • The person's ability to tolerate and comply with oral medication
  • Whether the patient appears hypoxic or toxic to the extent that the physician suspects a bacteremic pneumonia
  • Whether the person is immunosuppressed

Relatively few patients with M pneumoniae pneumonia require hospitalization based on these criteria.

Antimicrobial therapy

Experts formerly believed that mycoplasmal respiratory tract infections were entirely self-limited and that antimicrobial treatment was not indicated.

Appropriate antimicrobial therapy shortens the symptomatic period and hastens radiological resolution of pneumonia and recovery, even though patients may shed organisms for several weeks.

When treating community-acquired pneumonia, physicians usually must provide empiric coverage for several different bacterial agents that may be responsible because the microbiologic diagnosis is seldom available at the initiation of treatment. Fortunately, many of the drugs of choice for treating M pneumoniae provide broad-spectrum coverage for other organisms.