Application of budesonide in treatment of children with macrolide-resistant Mycoplasma pneumoniae pneumonia complicated with wheezing

Liu Qing; Chang Yanmei; Yu Lijuan; Wang Yuanyuan; He Yong; Zhu Mingzhu; Qu Xiangmei; He Lan

doi:10.3969/j.issn.1672-8157.2025.03.022

Abstract：Objective To observe the efficacy of budesonide spray via bronchoscopy in treatment of children with macrolide-re-sistant Mycoplasma pneumoniae pneumonia complicated with wheezing.Methods A total of 68 children with macrolide-resistant Mycoplasma pneumoniae pneumonia and wheezing who were diagnosed and treated in Beijing Haidian Hospital from November 2023 to December 2024 were prospectively selected and randomly divided into the control group with 34 cases(conventional treat-ment combined with bronchopulmonary lavage)and the observation group with 34 cases(local spray treatment of budesonide was added on the basis of the control group).Both groups of children were continuously treated for two weeks.The clinical efficacy,symptom remission time,clinical symptom and sign scores,levels of inflammatory factors,lung function parameters,and incidence of postoperative complications were compared between the two groups before and after treatment.Results The total effective rate of the observation group reached 91.18%(31/34),higher than 70.59%of the control group(24/34)(χ2=4.660,P<0.05).The duration of resolution for fever,pulmonary rales,cough,shortness of breath,and wheezing of the observation group was respectively(4.12±1.24)days,(4.02±1.21)days,(4.21±1.15)days,(2.38±0.78)days and(4.11±1.15)days,shorter than(5.15±1.65)days,(5.59±1.60)days,(5.52±1.82)days,(3.24±0.94)days and(5.03±1.52)days of the control group(t=2.910,4.564,3.548,4.105,2.814,all P<0.05).The clinical symptom and sign score of the observation group was(1.26±0.30)points,lower than(1.91±0.26)points of the control group(t=9.547,P<0.05).Furthermore,the serum interleukin-6(IL-6)level of the observation group was(4.56±1.08)pg·mL-1,lower than(5.26±1.24)pg·mL-1 of the control group(t=2.482,P<0.05).The values for FEV1,FVC,and peak expiratory flow rate(PEF)of the observation group were respectively(1.86±0.60)L,(1.86±0.56)L and(3.95±1.13)L·s-1,higher than(1.57±0.51)L,(1.60±0.48)L and(3.42±1.03)L·s-1 of the control group(t=2.147,2.055,2.021,all P<0.05).The postoperative complications in both groups were low-grade fevers.The incidence of postoperative complications was 2.94%(1/34)in the observation group,5.88%(2/34)in the control group,and there was no significant difference between the two groups(χ2=0.000 1,P>0.05).Conclusion Budesonide spray via bronchoscopy can effectively relieve the clinical symptoms of the children with macrolide-resistant Mycoplasma pneumoniae pneumonia complicated with wheezing and improve lung function,with the safety favorable.