What is the first line treatment for Mycoplasma pneumoniae?

Mycoplasma pneumoniae is a common cause of atypical pneumonia, particularly in younger populations. The first-line treatment for infections caused by this organism is typically a macrolide antibiotic, such as azithromycin. Alternatively, doxycycline is also an effective option. The choice between these often depends on patient age, allergy status, and local resistance patterns.

Macrolides are particularly effective against Mycoplasma due to their mechanism of action, which inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. This is crucial because Mycoplasma pneumoniae lacks a cell wall, making it resistant to beta-lactam antibiotics, which target cell wall synthesis.

Doxycycline serves as a suitable alternative, especially in older children and adults, and is also effective against Mycoplasma pneumoniae due to its ability to inhibit protein synthesis as well.

Supportive care alone does not address the underlying infection, making it insufficient as a primary treatment method. Pyrimethamine and sulfadiazine are used for treating specific parasitic infections such as Toxoplasmosis and are not effective against Mycoplasma pneumoniae.

Thus, the combination of a macrolide or doxycycline represents the best first-line treatment approach