Question
I have been running a high fever for 6 consecutive days, with temperatures reaching 38.5°C each night and a peak of 39.2°C. After 4 days of intravenous azithromycin, I switched to rifampin and norfloxacin, and the fever was controlled. Blood tests showed a double-positive result for mycoplasma. What are the appropriate treatment methods?
Answer
Mycoplasma pneumonia is a respiratory infection caused by the Mycoplasma pneumoniae bacteria. Treatment usually involves choosing macrolide antibiotics such as rifampin or azithromycin. For children, the recommended dosage is 30 to 50 mg/kg per day, taken four times orally, with a treatment course of 2 to 3 weeks. New-generation macrolide drugs like roxithromycin have fewer gastrointestinal side effects and higher serum concentrations, allowing for a reduced dosage to 5 mg/kg per day, taken twice orally. The initial dose of azithromycin can be 10 mg/kg, followed by a daily dose of 5 mg/kg for 5 consecutive days. Due to the longer half-life of azithromycin, the efficacy can last for about a week after discontinuation. Additionally, norfloxacin or ciprofloxacin can be considered, taken at 0.4 grams each time, twice daily, for a course of 5 to 7 days. In terms of care, it is important to note that Mycoplasma pneumoniae is mainly transmitted through oral and nasal secretions, can cause sporadic and small-scale outbreaks, and is more common in children and adolescents, often occurring during the autumn and winter seasons. Patients often experience symptoms such as headache and persistent cough, which can be healed within about 2 weeks with appropriate treatment. Adults usually have antibodies in their serum, making them less susceptible to infection. The preventive effect of the mycoplasma vaccine is currently uncertain, but intranasal administration of attenuated live vaccines may have some preventive effect.