Therapeutic efficacy and safety of doxycycline and levofloxacin for treating macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children
WU Yanwen
JIA Wanyu
GUO Caili
SONG Chunlan
Abstract：Objective To evaluate the efficacy and safety of doxycycline and levofloxacin in the treatment of macro-lide-unresponsive Mycoplasma pneumoniae pneumonia in children.Methods A retrospective analysis was performed on 200 children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia,including 100 cases treated with doxycy-cline(doxycycline group)and 100 cases treated with levofloxacin(levofloxacin group).The length of hospital stay,dura-tion of drug use,time to cough relief,the number of cases with defervescence within 24 h,and the levels of inflammatory markers[white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)]on admission and before discharge were recorded and compared between the two groups.Clinical efficacy and adverse reac-tions during treatment were also analyzed.Results The hospitalization duration in the doxycycline group was(7.96±1.34)days,while that in the levofloxacin group was(7.49±1.21)days(P>0.05).The number of days of medication use in the doxycycline group was(6.43±1.43)days,the number of days until cough improvement was(8.44±3.41)days,and 65 cases achieved fever resolution within 24 hours,while the levofloxacin group had(6.55±1.35)days,(8.78±4.26)days,and 54 cases,respectively.No statistically significant differences were found between the two groups(all P>0.05).Both groups showed significant decreases in WBC,CRP,PCT,and IL-6 levels post-treatment com-pared with those before treatment(all P<0.05).There were no statistically significant differences in pre-and post-treat-ment levels of WBC,CRP,PCT,or IL-6 between the levofloxacin and doxycycline groups(all P>0.05).The doxycy-cline group showed marked improvement in 63 cases,improvement in 34 cases,and no improvement in 3 cases.The levo-floxacin group showed marked improvement in 61 cases,improvement in 33 cases,and no improvement in 6 cases.There was no statistically significant difference in clinical efficacy between the two groups(P>0.05).During treatment,the dox-ycycline group had 2 cases of maculopapular rash,1 case of mild abdominal pain,and 10 cases of injection site pain.In the levofloxacin group,4 patients developed maculopapular rash,2 experienced mild abdominal pain,and 2 reported calf pain on the third day of infusion.No statistically significant difference was found in the incidence of adverse reactions be-tween the two groups(P>0.05).No new adverse reactions were reported during follow-up at 2 weeks and 1 month after dis-charge.Conclusions For children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia,treatment with doxycycline or levofloxacin can achieve good therapeutic effects and is relatively safe.
Keywords：doxycyclinelevofloxacinmycoplasma pneumoniaechildren
Publication Date：2026-01-25
Online Publishing Date：2026-03-05(First online date of this platform, not the publication date of the document)
Pages：5( 69-73 )