Early clinical predictors of macrolide-resistant Mycoplasma pneumoniae pneumonia in hospitalized children during the 2024 outbreak in South Korea.

Compared with macrolide-sensitive infections, MRMP was associated with older age, higher inflammatory markers, lower mycoplasma pneumoniae PCR cycle threshold (Ct) values, and more pulmonary complications.

Multivariable analysis identified elevated erythrocyte sedimentation rate (erythrocyte sedimentation rate) and lower PCR Ct as robust, independent predictors of macrolide resistance.

Integrating the PCR Ct value into a baseline clinical model significantly improved prediction accuracy, increasing the area under the curve (AUC) from 0.659 to 0.806.