Pediatric Mycoplasma Infections Treatment & Management

Updated: Apr 17, 2018
  • Author: Archana Chatterjee, MD, PhD; Chief Editor: Russell W Steele, MD  more...
  • Print

Medical Care

Antimicrobial therapy is not necessary for mycoplasmal infection of the upper respiratory tract.

An increase in macrolide-resistant M pneumoniae (MRMP) has been reported. [66, 67] This resistant form can be associated with prolonged severe respiratory infection in children. [68] Although pneumonia is self-limiting and is not life threatening in most patients, treatment with appropriate antimicrobials may shorten the duration of illness and perhaps reduce spread to contacts.

Using genotypic and phenotypic methods, Zheng et al detected high-level MRMP in 13.2% of 91 M pneumoniae–positive specimens from 6 United States locations. Macrolides should remain the drugs of choice in children with M pneumoniae respiratory infections, but with the emergence of high-level MRMP in all 6 centers throughout a broad geographic area in the United States, clinicians should be vigilant for macrolide treatment failures. [69]

Management of genitourinary diseases in which Mycoplasma species may play a role depends on recognizing the clinical syndromes for which antimicrobial therapy may be appropriate. Consider using antimicrobials that are active against mycoplasmal organisms in nongonococcal urethritis and pelvic inflammatory disease. Extrapulmonary complications are likely to be associated with an autoimmune response; thus, immunosuppressive therapy using steroids and intravenous immunoglobulin may be helpful. [53, 70]



Surgical Care

Surgical treatment is typically not needed.



Although consultations are usually not needed, in severe cases, admission to the ICU and consultation with critical care specialists, pulmonologists, and infectious disease physicians may be warranted. In patients who present with extrapulmonary manifestations, consult appropriate subspecialists.



Activity is as tolerated by the patient.