Objective: To probe into the clinical characteristics of macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMPP) in children and the efficacy of macrolide drugs. Methods: A total of 142 children with M. pneumoniae pneumonia (MPP) admitted into Hunan Children’s Hospital from 2016 to 2019 were prospectively collected. DNA and macrolide drug resistance genes of M. pneumoniae (MP) were detected. According to the polymerase chain reaction (PCR) results

all patients were divided into the drug resistance group (MR group) with 92 cases and sensitive group (MS group) with 50 cases. MR group was divided into the azithromycin group (group A) with 67 cases and non-macrolide group (group N) with 25 cases according to primary antibiotics. The clinical indicators

efficacy and extrapulmonary complications were analyzed. Results: There was no significant difference in age

gender

white blood cell (WBC)

neutrophilic granulocyte percent

C-reactive protein (CRP) and procalcitonin (PCT) levels between the MR group and the MS group (P>0.05). Compared with the MS group

the total fever duration

disappearance time of pulmonary rales

course of azithromycin treatment

and the fever duration after azithromycin treatment were prolonged in the MR group (P<0.05). There was no significant difference in age

course of antibiotics

fever duration after antibiotics treatment

neutrophilic granulocyte percent

CRP

PCT between the group A and the group N (P>0.05). Compared with group A

the total fever duration and disappearance time of pulmonary rales in group N were prolonged (P<0.05). The level of WBC in the group N was higher than that in the group A (P<0.01). There was no significant difference in total effective rate between the MR group and the MS group (P>0.05). The incidence of extrapulmonary complications in the MR group was higher than that in the MS group (P<0.05). Conclusion: The incidence of MRMPP in children is high

which leads to prolonged course of disease and increased extrapulmonary complications

yet prolonged course of treatment with amphotericin remains effective. Therefore

early diagnosis and early treatment with azithromycin make a significant difference in improving the spread of MP resistance.