In older children with community-acquired pneumonia due to Mycoplasma pneumoniae, which antibiotic is appropriate?

In older children with community-acquired pneumonia due to Mycoplasma pneumoniae, which antibiotic is appropriate?

• A. Azithromycin
• B. Amoxicillin
• C. Ceftriaxone
• D. Clindamycin

Answer: (A)

Mycoplasma pneumoniae causes atypical pneumonia in school-age children, and these organisms lack a cell wall. That makes beta-lactam antibiotics (like amoxicillin or ceftriaxone) ineffective, because those drugs target cell wall synthesis. Therapy should instead target the organism’s protein synthesis. Macrolides, such as azithromycin, bind the 50S ribosomal subunit and reliably treat Mycoplasma infections in children. So azithromycin is the appropriate choice. Clindamycin is not as reliably effective for Mycoplasma, and the beta-lactams wouldn’t work for this pathogen, leaving azithromycin as the best option.

Mycoplasma pneumoniae causes atypical pneumonia in school-age children, and these organisms lack a cell wall. That makes beta-lactam antibiotics (like amoxicillin or ceftriaxone) ineffective, because those drugs target cell wall synthesis. Therapy should instead target the organism’s protein synthesis. Macrolides, such as azithromycin, bind the 50S ribosomal subunit and reliably treat Mycoplasma infections in children. So azithromycin is the appropriate choice. Clindamycin is not as reliably effective for Mycoplasma, and the beta-lactams wouldn’t work for this pathogen, leaving azithromycin as the best option.