Effects of Prednisolone on Refractory Mycoplasma Pneumoniae Pneumonia in Children

ObjectivesTo prospectively evaluate prednisolone treatment in children with refractory Mycoplasma pneumonia pneumonia (MPP). MethodsFifty-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 8hr after enrollment, infiltration absorption, atelectasis resolution, pleural effusion disappearance, and serum ferritin and LDH levels were assessed on seventh day after enrollment. ResultsAll patients in treatment group achieved defervescence during 8-48hr after enrollment versus no patient in the control group. The mean duration of hypoxemia was 1.90.9 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). ConclusionsAzithromycin combined with prednisolone is a better treatment for children with refractory MPP than azithromycin alone. Pediatr Pulmonol. 2014; 49:377-380. (c) 2013 Wiley Periodicals, Inc.