Admission-Based Prediction of Macrolide Resistance in Children Aged >28 Days and ≤8 Years with Mycoplasma pneumoniae Pneumonia: A Retrospective Prediction Model Study

Purpose

Macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMP) complicates the management of pediatric Mycoplasma pneumoniae pneumonia (MPP), especially around the 8-year treatment threshold, where second-line antimicrobial choices require careful risk-benefit assessment. This study aimed to develop and internally validate an admission-based model for predicting macrolide resistance in children aged > 28 days and ≤ 8 years with MPP. Patients and Methods: This single-center retrospective prediction model study included hospitalized children with confirmed MPP at the First Affiliated Hospital of Jiamusi University from October 2023 to October 2024. Candidate predictors were restricted to demographic and laboratory variables available at admission or during early hospitalization. Univariable analyses were followed by multivariable logistic regression with stepwise selection. Model performance was assessed by receiver operating characteristic (ROC) analysis, calibration plots, decision curve analysis (DCA), and bootstrap internal validation.