Empiric antibiotic therapy for Mycoplasma pneumoniae pneumonia in children: A Pro/Con Discussion.

Mycoplasma pneumoniae is a common respiratory pathogen of increasing clinical interest as cases have recently risen in the United States and worldwide following a period of reduced activity during the COVID-19 pandemic. While most cases are mild, Mycoplasma pneumoniae can cause severe community-acquired pneumonia (CAP), and cannot be reliably distinguished from other common causes of CAP based solely on features of clinical presentation or imaging. However, testing to confirm a diagnosis of M. pneumoniae, when it is suspected, can be logistically challenging in some clinical settings. It also remains unclear which patients with M. pneumoniae CAP benefit from antibiotic treatment, raising the question of whether treatment should be offered, particularly when the diagnosis is not confirmed. This pro/con discussion explores the available data to support or refute routine testing and empiric antibiotic treatment for M. pneumoniae.