Comparison of the efficacy of doxycycline and azithromycin combined with methylprednisolone in the treatment of MUMPP in children
YANG Jingxia
DUAN Lufen
MAO Jun
XIE Shuyan
Abstract：Objective To investigate the clinical efficacy of doxycycline combined with methylprednisolone in the treatment of macrolide-nonresponsive Mycoplasma pneumoniae pneumonia(MUMPP)in children.Methods A retrospective controlled study design was adopted.A total of 172 children with MUMPP who visited Suzhou Municipal Hospital from July 2023 to December 2024 were initially screened for this retrospective comparative study.After excluding cases that did not meet the inclusion criteria or were lost to follow-up during treatment,150 cases were ultimately included.Based on different treat-ment regimens,they were divided into two groups:75 cases receiving azithromycin combined with methylprednisolone were assigned to the azithromycin group,and 75 cases receiving doxycycline combined with methylprednisolone were assigned to the doxycycline group.The inflammatory level,immune level,clinical efficacy,post-treatment symptom improvement and in-cidence of adverse reactions were evaluated before and after treatment in two groups.Results The total effective rate in the doxycycline group was 92.00%(69/75),higher than that in the azithromycin group(80.00%(60/75))(χ2=4.485,P<0.05).After treatment,the time to fever resolution,cough relief,disappearance of lung rales,and hospitalization length in the doxycycline group((4.51±1.37),(5.62±1.53),(4.78±1.24),(8.59±2.36)days,respectively)were all lower than those in the azithromycin group((7.24±2.83),(8.15±2.46),(6.92±1.85),(12.33±3.72)days,respectively)(t=7.519,7.563,8.321,7.352,all P<0.05).After treatment,the levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein in the doxycycline group((11.64±4.36)ng/L,(2.85±0.86)ng/L,(32.33±6.72)mg/L,respectively)were all lower than those in the azithromycin group((17.83±4.75)ng/L,(4.92±1.01)ng/L,(47.52±6.16)mg/L,respectively)(t=8.314,13.514,14.430,all P<0.05).After treatment,the levels of CD3+and CD4+/CD8+ratio in the doxycycline group((74.82±4.08)%,(1.77±0.28),respectively)were higher than those in the azith-romycin group((68.85±4.53)%,(1.47±0.26),respectively)(t=8.481,6.799,both P<0.05).No statistically significant difference was observed in the incidence of adverse reactions between the two groups(8.00%(6/75)vs 5.33%(4/75),χ2=0.429,P>0.05).Conclusion The combination of doxycycline and methylprednisolone is effective in treating MUMPP in children,significantly improving clinical outcomes and symptoms,modulating inflammatory and immune responses,with a favorable safety profile.
Keywords：doxycyclinemethylprednisolonemacrolide-nonresponsive Mycoplasma pneumoniae pneumoniainflam-matory responseclinical efficacy
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 262-266 )