Effect of Azithromycin Sequential Therapy Combined with Methylprednisolone on Pulmonary Function Indices and Immune Indices in Children with Severe Mycoplasma Pneumonia

Lan LIU; Xuejun ZHAO; Hongju FANG

Article Contents

Article Navigation > Journal of Kunming Medical University > 2026 > Accepted Manuscript

Lan LIU, Xuejun ZHAO, Hongju FANG. Effect of Azithromycin Sequential Therapy Combined with Methylprednisolone on Pulmonary Function Indices and Immune Indices in Children with Severe Mycoplasma Pneumonia[J]. Journal of Kunming Medical University.

Citation:

PDF( 1536 KB)

Effect of Azithromycin Sequential Therapy Combined with Methylprednisolone on Pulmonary Function Indices and Immune Indices in Children with Severe Mycoplasma Pneumonia

Department of Pediatrics，Youxian District Maternal and Child Health Hospital，Mianyang Sichuan 621000，China

Received Date: 2026-03-02

Abstract

Abstract

Objective To investigate the effects of azithromycin sequential therapy combined with methylprednisolone on pulmonary function indices and immune indices in children with severe Mycoplasma pneumonia. Methods A retrospective analysis was conducted on the clinical data of 150 children with severe Mycoplasma pneumoniae pneumonia admitted to a certain hospital from January 2023 to June 2025. According to different treatment modalities, they were divided into a study group（n = 75, treated with azithromycin sequential therapy combined with methylprednisolone） and a control group（n = 75, treated with azithromycin sequential therapy） .The clinical efficacy, inflammatory factors, pulmonary function indices, immune indices, and adverse reactions of the two groups were compared. Results After treatment, the clinical pulmonary infection score, levels of interleukin-6, procalcitonin, soluble programmed death receptor ligand 1, and high-sensitivity C-reactive protein, as well as chest imaging score and airway mucosal inflammation score in the study group were all lower than those in the control group （P < 0.05）. The maximum voluntary ventilation, forced expiratory volume in the first second, peak expiratory flow, forced vital capacity, forced expiratory flow at 75% of vital capacity, forced expiratory flow at 50% of vital capacity, and levels of immunoglobulin A, immunoglobulin G, complement C3, and complement C4 were all higher than those in the control group, and the duration of fever, cough, sputum production, and moist rales were shorter than those of the control group （P < 0.05）; After treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups, and there was no significant improvement in the study group （P > 0.05）. Conclusion Azithromycin sequential therapy combined with methylprednisolone can improve the levels of inflammatory factors and pulmonary function indices, regulate immunity, and enhance therapeutic efficacy in children with severe Mycoplasma pneumoniae pneumonia, with a certain level of safety.
- Azithromycin,
- Methylprednisolone,
- Severe Mycoplasma pneumoniae pneumonia in children,
- Safety

FullText(HTML)

References(25)

References

[1]	闫敏, 王沂霞, 田涛, 等. 基于胸部CT征象与肺炎支原体抗体水平构建小儿肺炎支原体肺炎的诊断模型[J]. 中国医学计算机成像杂志, 2025, 31(2): 246-250. doi: 10.3969/j.issn.1006-5741.2025.02.017
[2]	柴彦艳, 邓芳, 许愿愿, 等. 重症肺炎支原体肺炎患儿临床特征与实验室指标及预后的关系[J]. 中华医院感染学杂志, 2025, 35(20): 3124-3127. doi: 10.11816/cn.ni.2025-250589
[3]	李晋菊, 朱江川, 宋瑞. 重症肺炎患儿支气管肺泡灌洗液中肺炎支原体的检测及其对阿奇霉素治疗反应的回顾性分析[J]. 临床和实验医学杂志, 2025, 24(4): 409-413. doi: 10.3969/j.issn.1671-4695.2025.04.018
[4]	杨峥蓉, 窦海伟, 蔡宇昂, 等. 肺炎支原体288株对阿奇霉素和红霉素的最小抑菌浓度及其耐药基因变异研究[J]. 中华实用儿科临床杂志, 2025, 40(10): 771-774. doi: 10.3760/cma.j.cn101070-20250514-00350
[5]	Meyer Sauteur P M, Seiler M, Tilen R, et al. A randomized controlled non-inferiority trial of placebo versus macrolide antibiotics for Mycoplasma pneumoniae infection in children with community-acquired pneumonia: Trial protocol for the MYTHIC Study[J]. Trials, 2024, 25(1): 655. doi: 10.1186/s13063-024-08438-6
[6]	Meduri G U, Shih M C, Bridges L, et al. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia[J]. Intensive Care Med, 2022, 48(8): 1009-1023. doi: 10.1007/s00134-022-06684-3
[7]	中华人民共和国国家卫生健康委员会. 儿童肺炎支原体肺炎诊疗指南(2023年版)[J]. 国际流行病学传染病学杂志, 2023, 50(2): 79-85.
[8]	Gaudet A, Martin-Loeches I, Povoa P, et al. Accuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumonia[J]. Ann Intensive Care, 2020, 10(1): 101. doi: 10.1186/s13613-020-00721-4
[9]	刘松, 谢红, 余成新, 等. 新型冠状病毒肺炎患者的临床特点及肺部CT变化模式[J]. 放射学实践, 2020, 35(4): 421-427. doi: 10.13609/j.cnki.1000-0313.2020.04.004
[10]	Thomas R J, Eg K P, Masters I B, et al. Towards developing a valid scoring tool for bronchitis during flexible bronchoscopy[J]. Pediatr Pulmonol, 2018, 53(11): 1510-1516. doi: 10.1002/ppul.24163
[11]	Vidal A G J, Alibayov B, Frame I J, et al. Induction of the macrolide-resistance efflux pump Mega inhibits intoxication of Staphylococcus aureus strains by Streptococcus pneumoniae[J]. Microbiol Res, 2022, 263: 127134. doi: 10.1016/j.micres.2022.127134
[12]	高珊, 马亚波, 董艳菊. 低剂量甲基强的松龙对重症肺炎患儿短期预后的影响研究[J]. 中国急救复苏与灾害医学杂志, 2022, 17(11): 1470-1473. doi: 10.3969/j.issn.1673-6966.2022.11.018
[13]	吴维仪, 董琴琴, 梁明欣, 等. 维生素D联合阿奇霉素治疗小儿肺炎支原体肺炎的疗效及对血清炎症因子和T淋巴细胞亚群的影响[J]. 转化医学杂志, 2025, 14(4): 166-170. doi: 10.3639/j.issn.2095-3097.2025.04.032
[14]	Greco Kinney A, Kovacic Scherrer N, Sarkar S, et al. β-Lactams plus doxycycline versus azithromycin for treatment of severe community-acquired pneumonia in critically ill patients[J]. J Antimicrob Chemother, 2023, 78(12): 2816-2823. doi: 10.1093/jac/dkad301
[15]	殷平辉, 张文静, 吴佳妮, 等. 孟鲁司特钠联合阿奇霉素对难治性肺炎支原体肺炎患儿肺功能、肺部炎症及血TLR2信号通路相关因子、microRNA-1323表达的影响[J]. 西北药学杂志, 2025, 40(6): 22-29. doi: 10.3969/j.issn.1004-2407.2025.06.004
[16]	唐超智, 耿晓柯, 张玉玲, 等. 阿奇霉素的免疫治疗机制[J]. 中国免疫学杂志, 2021, 37(14): 1768-1771. doi: 10.3969/j.issn.1000-484X.2021.14.021
[17]	张哲梅, 魏莲花, 王丹妮, 等. CRP、SAA、IL-6、PCT及WBC在儿童上呼吸道感染及消化道感染性疾病中的诊断价值[J]. 标记免疫分析与临床, 2023, 30(6): 953-959. doi: 10.11748/bjmy.issn.1006-1703.2023.06.011
[18]	贺新伟, 骆琼珍, 赵丽丽, 等. 成人社区获得性肺炎患者血清可溶性程序性死亡受体配体-1的表达及意义[J]. 中华内科杂志, 2021, 60(3): 243-246. doi: 10.3760/cma.j.cn112138-20200306-00200
[19]	Huang Y, Chen Y, Liu M, et al. Comparative analysis of Chlamydia pneumoniae pneumonia (CPP) and Mycoplasma pneumoniae pneumonia in children and risk factors of severe CPP[J]. BMC Infect Dis, 2025, 25(1): 993. doi: 10.1186/s12879-025-11405-4
[20]	高世悦, 朱保卫. 红霉素和阿奇霉素序贯治疗小儿肺炎支原体肺炎的临床疗效和不良反应观察[J]. 贵州医药, 2022, 46(9): 1393-1394. doi: 10.3969/j.issn.1000-744X.2022.09.027
[21]	闫若原, 梁金玲, 梁爽. 甲泼尼龙联合盐酸氨溴索治疗儿童社区获得性肺炎的疗效[J]. 中国药物应用与监测, 2025, 22(6): 1116-1119. doi: 10.3969/j.issn.1672-8157.2025.06.034
[22]	尹力, 王雪, 高密密, 等. 甲泼尼龙琥珀酸钠辅助治疗儿童重症肺炎支原体肺炎的临床疗效分析及对患儿血LDH、CRP和T淋巴细胞亚群的影响[J]. 中国生育健康杂志, 2025, 36(4): 334-338+359. doi: 10.3969/j.issn.1671-878X.2025.04.007
[23]	杜博英, 郭在强, 刘杰, 等. 阿奇霉素治疗肺炎支原体肺炎发生不良反应列线图预测模型的构建与验证[J]. 临床与病理杂志, 2025, 45(4): 443-451. doi: 10.11817/j.issn.2095-6959.2025.240919
[24]	黄斌, 时澄. 甲泼尼龙治疗儿童呼吸系统疾病所致不良反应85例分析[J]. 中国药物应用与监测, 2025, 22(1): 166-169. doi: 10.3969/j.issn.1672-8157.2025.01.038
[25]	李红桥, 夏雯, 李兰, 等. 多西环素与阿奇霉素治疗儿童支原体肺炎有效性、安全性及经济学比较[J]. 中国药业, 2025, 34(4): 115-118. doi: 10.3969/j.issn.1006-4931.2025.04.028

Relative Articles(20)

Relative Articles

[1]	Qinglan PENG, Jialu LUO, Jiayi YU, Kaixin WANG, Fang WU, Chuanzhi XU. Signal Mining and Analysis of Adverse Events of Azithromycin Based FAERS Database. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250103
[2]	Fen TENG, Bo TIAN, Chongxi LI, Yongmei JIN, Haiyun CHEN, Jun LIU. Real-World Clinical Efficacy and Safety of Bictegravir/Emtricitabine/Tenofovir Alafenamide （BIC/FTC/TAF） Single-Tablet Regimen. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240411
[3]	Yibiao GUAN, Sheng HUANG, Libo LI. Effect of Hybrid Blood Purification on Dialysis Adequacy，Immunity，and Inflammation in ESRD Patients with Inadequate Peritoneal Dialysis. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240818
[4]	Liyuan YUN, Junfeng WANG, Ning GUO, Ruimei DING, Haipeng LI, Xueping ZHANG. Analysis of the Efficacy and Safety of GM1 Injection Combined with Batroxobin in the Treatment of Sudden Deafness Patients. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240619
[5]	Keyan WANG, Bingting LIN, Xiaolin WENG, Bin HUANG, Lie WANG. Effectiveness and Safety Analysis of Cyclopol Combined with Remifentanil in Anesthesia for Endoscopic Gastric Cancer Radical Surgery. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20240621
[6]	Ling ZHAO, Hongling ZHONG, Xinru GAO, Mei LI, Tingting MAO, Rongyong LI, Tingyu KE. Clinical Observation of SGLT-2 Inhibitors in Delaying the Progression of Diabetic Nephropathy. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230527
[7]	Weixing DING, Siyan WANG, Chen ZHOU, Jianyou TIAN, Yalin TAO, Ting LI, Huijuan PENG. Application of High Epidural Combined General Anesthesia in Laparoscopic Liver Resection. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230203
[8]	Jianmei LI, Yanling JIN. Efficacy and Safety of Bortezomib，Lenalidomide Combined with Dexamethasone in the Treatment of Multiple Myeloma. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230610
[9]	Zhi-rong ZHAO, Hai-wen LI, Ni-hong LU, Ling SHEN, Xiao-fei LI, Yong-rui YANG. A Clinical Study on the Use of Propofol Tenofovir in the Treatment of Chronic Hepatitis B. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20210141
[10]	Chang Song Jie . The Clinical Efficacy and Safety of Decreasing Blood Uric Acid by Benzene Bromine Malone in Treatment of Hyperuricemia with Elderly Hypertension and Diabetes Mellitus. Journal of Kunming Medical University,
[11]	Pan Zi Peng . Analysis and Safety Evaluation of the Clinical Efficacy of Laparoscopic Appendectomy for Acute Appendicitis. Journal of Kunming Medical University,
[12]	Luo Yong Li . Clinical Assessment on the Safety of Cardiac Rehabilitation for the Elderly Patients with Chronic Heart Failure. Journal of Kunming Medical University,
[13]	Ke Zi Li . . Journal of Kunming Medical University,
[14]	Zeng Hai Ping . . Journal of Kunming Medical University,
[15]	Wang Ji Cai . . Journal of Kunming Medical University,
[16]	Li Kai . . Journal of Kunming Medical University,
[17]	Li Gui Ling . . Journal of Kunming Medical University,
[18]	Li Gui Ling . . Journal of Kunming Medical University,
[19]	Yan Jin . . Journal of Kunming Medical University,
[20]	Wang Ji Cai . . Journal of Kunming Medical University,