Comparative Clinical Efficacy of Doxycycline versus Levofloxacin in the Treatment of Drug-Resistant Mycoplasma Pneumoniae Infections: A Thematic Report

Background: In 2024, a nationwide pandemic of drug-resistant Mycoplasma pneumoniae emerged, increasing treatment challenges. Children were treated with medications contraindicated or used with caution in pediatric patients, such as intravenous levofloxacin and oral doxycycline, leading to prolonged treatment duration, high costs, significant antibiotic side effects, and insufficient research on long-term impacts. In the second half of 2024, the number of drug-resistant Mycoplasma pneumoniae cases surged in our hospital, prompting the clinical implementation of nucleic acid testing for Mycoplasma resistance, targeting the 23S rRNA gene locus. Objective: Based on clinical data of Mycoplasma pneumoniae infections in our hospital, this retrospective case-control study compares oral doxycycline and intravenous levofloxacin treatment groups for drug-resistant Mycoplasma pneumoniae infections to enhance diagnostic and treatment standards, reduce drug side effects, and decrease the risk of pathogen resistance. Methods: A retrospective case-control study design was employed, comparing the oral doxycycline treatment group with the intravenous levofloxacin treatment group. Results: Using t-tests and chi-square tests for statistical analysis, the conclusions are as follows: 1. There was a statistically significant difference in the average time to drug efficacy between oral doxycycline and intravenous levofloxacin. Oral doxycycline showed a significantly faster onset of action in this patient population compared to intravenous levofloxacin. 2. The difference in the proportion of "off-label drug use" between the oral doxycycline group and the intravenous levofloxacin group was extremely statistically significant. These findings indicate that oral doxycycline offers greater advantages and should be the preferred choice for treating drug-resistant Mycoplasma infections in older children (over 8 years old). Clinical trial number: not applicable.