Effects of Prednisolone on Refractory Mycoplasma Pneumoniae Pneumonia in Children

Objectives: To prospectively evaluate prednisolone treatment in children with refractory Mycoplasma pneumonia pneumonia (MPP).

Methods: Fifty-eight refractory children with MPP were enrolled to receive either azithromycin combined with prednisolone (treatment group, n = 28) or azithromycin alone (control group, n = 30). Temperature, respiratory symptoms and signs were examined at the time of study entry and every 8 hr after enrollment, infiltration absorption, atelectasis resolution, pleural effusion disappearance, and serum ferritin and LDH levels were assessed on seventh day after enrollment.

Results: All patients in treatment group achieved defervescence during 8-48 hr after enrollment versus no patient in the control group. The mean duration of hypoxemia was 1.9 ± 0.9 days in treatment group and 2.7 ± 1.1 days in the control group (P < 0.05), and the dyspnea resolved time was 1.5 ± 0.7 days and 2.9 ± 0.6 days (P < 0.05), respectively. Seven days after enrollment, 80% of patients in treatment group showed infiltration absorption versus 21.4% in control group (P < 0.05); the figures for atelectasis resolution were 71.4% versus 12.5% (P < 0.05), and for pleural effusion disappearance 88.9% versus 20.0% (P < 0.05). The serum ferritin and LDH level was lower in the treatment than that in control group (P < 0.05).

Conclusions: Azithromycin combined with prednisolone is a better treatment for children with refractory MPP than azithromycin alone.