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Healthcare Leadership, Policy & Digital Health News India > Blog > Govt Health > Walking Pneumonia Rising in Kerala When Azithromycin Starts to Fail

Walking Pneumonia Rising in Kerala When Azithromycin Starts to Fail

Published: October 11, 2025
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Kerala is seeing a surge in walking pneumonia (Mycoplasma-type infections), especially among children, with reports that the go-to antibiotic azithromycin is being less effective. Experts warn that rising resistance and misuse of antibiotics are driving this downward shift.

Glimpse:

Health officials in Kerala note that walking pneumonia often milder but lingering respiratory illness has spread beyond the usual age group and symptoms are becoming harder to treat. Azithromycin, commonly prescribed for these atypical pneumonias, is showing reduced effectiveness. Contributing factors include antibiotic overuse, OTC access without prescription, and rising resistance among causative bacteria. The state is being pushed to update treatment guidelines and strengthen stewardship.

Doctors in Kerala are reporting a rise in cases of walking pneumonia, particularly among children under five. Symptoms include a persistent dry cough, mild fever, sore throat, and fatigue that lasts longer than a typical viral infection. This marks a shift from earlier patterns when mostly older children and adolescents were affected.

The illness is commonly caused by Mycoplasma pneumoniae, which has traditionally responded well to azithromycin. However, doctors are now seeing more cases where the antibiotic is less effective, with patients requiring longer treatment or stronger medications. Although large-scale studies are limited, clinical observations and lab data suggest growing resistance to azithromycin.

Experts attribute this trend to the overuse and misuse of antibiotics. Azithromycin and similar drugs are often sold without prescriptions, and many people use them unnecessarily for viral coughs and colds. Resistance among respiratory bacteria has risen sharply in recent years, reducing the reliability of once-effective treatments.

In response, doctors are revising treatment protocols, using alternative antibiotics and emphasizing proper antibiotic stewardship. Health authorities are urging stronger regulation of over-the-counter sales, better diagnostic testing, and public awareness to slow the spread of resistance and protect vulnerable children from severe pneumonia.

“Azithromycin was once a safe bet for walking pneumonia. Now, in many children, that bet is failing. If we don’t act now adjust guidelines, enforce stewardship, reduce misuse the next treatment line may cost many lives.”

By

HB Team

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