Susceptibility patterns- Most Mycoplasma pneumoniae infections are self-limiting, and do not require antibiotics. However, clinicians typically will treat based on several factors (eg, age, immune status).
- In general, all cell wall-deficient bacteria tend to be resistant to many of the more common antibiotics.
Intrinsic resistance
Penicillin and β-lactam drugs are highly ineffective treatments, as are sulfonamides and rifampin.
Antibiotics for treatment
Treatment for Mycoplasma pneumoniae is limited to macrolides (erythromycin, clarithromycin, azithromycin), tetracyclines (doxycycline) if nervous system involvement is present, and some of the newer quinolones are useful for adult immunocompromised patients. Treatment for M. genitalium may include tetracycline (doxycycline) and azithromycin or a quinolone but is dependent on whether the patient is pregnant.22
M. hominis and U. urealyticum/U. parvum are usually treated with tetracyclines; however, some resistance has been reported.23
The emergence of multi-drug-resistant mycoplasmas and ureaplasmas has been identified in immunocompromised patients.24
22. Lanao AE, Chakraborty RK, Pearson-Shaver AL. Mycoplasma Infections. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Accessed December 23, 2023. https://www.ncbi.nlm.nih.gov/books/NBK536927/ 23. Tille PM. Bailey & Scott's Diagnostic Microbiology. 15th ed. Elsevier. 2022.
