Current Practice in the Diagnosis and Management of Mycoplasma pneumoniae Infections: A Survey of Korean Physicians in 2024.

BACKGROUND: Macrolide-resistant Mycoplasma pneumoniae (MRMP) is a growing concern in pediatric pneumonia. This study investigated current diagnostic and treatment practices for M. pneumoniae infections among Korean pediatricians, focusing on variations and challenges related to MRMP management. METHODS: A cross-sectional online survey was conducted among Korean pediatricians, including general pediatricians and subspecialists in September 2024. The survey assessed diagnostic methods, antibiotic choices, corticosteroid use, and factors influencing treatment decisions. RESULTS: A total of 452 pediatricians participated in the survey. Polymerase chain reaction was the preferred diagnostic method (92.0%), although serologic tests were also commonly used (37.4%). Macrolides were the dominant first-line treatment (89.0%), with clarithromycin and roxithromycin being equally favored. Doxycycline was the most frequent second-line choice (67.0%). Corticosteroid use varied among specialties, with up to 94% of respondents using them occasionally or almost always. Treatment guidelines were the primary factor influencing antibiotic choices (76.5% for first-line, 59.7% for second-line). CONCLUSION: This study reveals diverse practices and a need for standardized guidelines in managing M. pneumoniae infections, particularly in the context of rising MRMP prevalence. Clearer recommendations on diagnostic testing, antibiotic selection, and corticosteroid use are crucial to optimize patient care and mitigate the spread of resistance.