medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-070medsovet-9209Research ArticleРАЦИОНАЛЬНАЯ ФАРМАКОТЕРАПИЯRATIONAL PHARMACOTHERAPYМикоплазменная пневмония: современная антибактериальная терапияMycoplasma pneumonia: Modern antibacterial therapyhttps://orcid.org/0000-0001-6528-1585ЛазареваН. Б.LazarevaN. B.

Лазарева Наталья Борисовна; д.м.н.; профессор кафедры клинической фармакологии и пропедевтики внутренних болезней

119991; Москва; ул. Трубецкая; д. 8; стр. 2

Natalia B. Lazareva; Dr. Sci. (Med.); Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8; Bldg. 2; Trubetskaya St.; Moscow; 119991

 

lazareva_n_b@staff.sechenov.ruhttps://orcid.org/0000-0002-2013-3455СоловьеваС. А.SolovievaS. S.

Соловьева Светлана Александровна; к.м.н.; ассистент кафедры клинической фармакологии и пропедевтики внутренних болезней

119991; Москва; ул. Трубецкая; д. 8; стр. 2

Svetlana S. Solovieva; Cand. Sci. (Med.); Assistant of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8; Bldg. 2; Trubetskaya St.; Moscow; 119991

soloveva_s_a@staff.sechenov.ruhttps://orcid.org/0000-0002-1184-0561ЕрмолаеваА. С.ErmolaevaA. S.

Ермолаева Анна Саввична; к.м.н.; доцент кафедры клинической фармакологии и пропедевтики внутренних болезней

119991; Москва; ул. Трубецкая; д. 8; стр. 2

Anna S. Ermolaeva; Cand. Sci. (Med.); Assistant of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8; Bldg. 2; Trubetskaya St.; Moscow; 119991

ermolaeva_a_s_1@staff.sechenov.ruhttps://orcid.org/0009-0003-9220-2602АндрееваМ. Е.AndreevaM. E.

Андреева Мария Евгеньевна; студент

119991; Москва; ул. Трубецкая; д. 8; стр. 2

Maria E. Andreeva; Student

8; Bldg. 2; Trubetskaya St.; Moscow; 119991

lukienko_m_e@student.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20252206202509183190Copyright © Лазарева Н.Б., Соловьева С.А., Ермолаева А.С., Андреева М.Е., 20252025Лазарева Н.Б., Соловьева С.А., Ермолаева А.С., Андреева М.Е.Lazareva N.B., Solovieva S.S., Ermolaeva A.S., Andreeva M.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9209

Mycoplasma pneumoniae (M. pneumoniae) является одним из ключевых патогенов, вызывающих развитие внебольничной пневмонии во всех странах мира, особенно у детей и подростков. Глобально инфекции M. pneumoniae возникают в различных регионах мира каждые 3–7 лет и длятся, как правило, 1–2 года. M. pneumoniae обладает факторами вирулентности, характеризующимися высокой аффинностью к эпителиальным клеткам респираторного тракта, прямым повреждающим эффектом, а также способностью взаимодействовать с клетками иммунной системы. Патогенез микоплазменной инфекции, в том числе пневмонии, включает как прямой повреждающий эффект, так и опосредованные иммунным ответом организма васкулиты и тромбозы. Макролиды используются в качестве основного класса антибиотиков для лечения микоплазменной инфекции. Они подавляют рост бактерий, связываясь с 23S рРНК и ингибируя синтез белка. Однако устойчивые к макролидам штаммы M. pneumoniae (MRMP) получили широкое распространение в странах Азии с 2000 г., составляя на сегодняшний день около 80–90% случаев микоплазменной инфекции в Китае и Японии, в то же время уровень обнаружения MRMP очень низок в европейских странах и США. Азитромицин и кларитромицин обладают высокой биодоступностью, стабильны при кислом pH, пероральные формы не требуют покрытия кишечнорастворимой оболочкой. Диспергируемые формы таблеток (азитромицин) и суспензии для приема внутрь могут использоваться пациентами независимо от приема пищи, что обеспечивает удобство приема. В то время как лекарственные формы азитромицина с медленным высвобождением должны приниматься исключительно на пустой желудок, а пролонгированные формы кларитромицина, наоборот, следует принимать с пищей.

Mycoplasma pneumoniae (M. pneumoniae) is one of the key pathogens causing the community-acquired pneumonia in all countries, especially in children and adolescents. Globally, M. pneumoniae infections occur in different regions of the world every 3–7 years and last 1–2 years. M. pneumoniae has infective factors characterized by high affinity to the epithelial cells of the respiratory tract, direct damaging effect, as well as ability to interact with immune system cells. The pathogenesis of mycoplasma infection, i.e. pneumonia, includes both direct damage and immune response mediated by vasculitis and thrombosis. Macrolides are used as the main class of antibiotics for the treatment of mycoplasma infection. They inhibit bacterial growth by binding to 23S rRNA and inhibiting protein synthesis. However, macrolide-resistant strains of M. pneumoniae (MRMP) have become widespread in Asia since 2000, accounting for about 80–90% infections in China and Japan today, at the same time, the detection rate of MRMP is very low in European countries and the US. Azithromycin and clarithromycin have high bioavailability, are stable at acidic pH, oral forms do not require intestinal coating. Instant soluble drug forms (azithromycin) and suspension can be used by patients regardless of food intake, which ensures convenience. While the slow released drug forms of azithromycin should be taken only on an empty stomach, the slow released extended forms of clarithromycin should be taken with food.

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The authors declare that there are no conflicts of interest present.