For children hospitalized with community-acquired pneumonia, there is no significant difference between treatment with beta-lactam monotherapy and beta-lactam plus macrolide combination therapy.

“Macrolide antibiotics possess in vitro activity against Mycoplasma pneumoniae and Chlamydophila pneumoniae, and the [IDSA] guideline recommends their use when such pathogens are suspected,” Derek J. Williams, MD, MPH, from the division of hospital medicine in Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center, and colleagues wrote. “However, with few clinical studies demonstrating the effectiveness of macrolides in children, the guideline grades this recommendation as weak.”

The researchers note that because macrolides are frequently used as empirical therapy for pediatric pneumonia, it is important that the benefits of macrolide therapy plus beta-lactam are established.