Volume 11,Issue 2
Comparison of the Efficacy of Two Initial Treatment Regimens for Macrolide-Unresponsive Mycoplasma Pneumoniae Pneumonia in Children
Objective: To compare the clinical efficacy of two first-line regimens—azithromycin combined with methylprednisolone versus doxycycline monotherapy—in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) in children. Methods: A retrospective study design was adopted. Children with MUMPP hospitalized in our institution from January 2023 to December 2023 were enrolled and divided according to their initial treatment regimen into Group A (azithromycin + methylprednisolone) and Group B (doxycycline monotherapy). Only cases that achieved clinical cure following the initial regimen were included in the between-group comparative analysis. The adjusted length of hospital stay required for clinical cure, time to effective defervescence, and pulmonary imaging resolution were compared between the two groups. Between-group comparisons were performed using the chi-squared test and the Mann–Whitney U test. Results: A total of 79 children with MUMPP who responded to treatment and met the discharge criteria for clinical cure were included, comprising 39 in Group A and 40 in Group B. No statistically significant difference in pulmonary imaging findings at discharge was observed between the two groups (P>0.05). The adjusted length of hospital stay was significantly shorter in Group B than in Group A (5 (IQR, 4–6) days vs. 7 (IQR, 6–9) days, p = 0.005). The time to effective defervescence did not differ significantly between the two groups. No serious adverse events occurred in either group. Conclusion: In children with MUMPP who respond to initial treatment, azithromycin combined with methylprednisolone and doxycycline monotherapy demonstrate comparable efficacy in terms of time to defervescence and final pulmonary imaging resolution; however, doxycycline significantly shortens the length of hospital stay required to achieve clinical cure.
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