Abstract：Objective To investigate the effect and safety of low dose Methylprednisolone combined with Azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia （RMPP） in children. Methods A total of 84 children with RMPP treated in our hospital from December 2014 to August 2018 were selected as the study subjects.According to the random number table method, the children were divided into observation group （n=43） and control group （n=41）.The children in the two groups were given expectoration, oxygen inhalation, maintenance of water electrolyte and acid-base balance.Azithromycin was given intravenously in the control group, and low dose Methylprednisolone was given in the observation group on the basis of the control group for 7 d.The time of hospitalization, the recovery time of body temperature, the level of C-reactive protein （CRP） before and after treatment and effect in the two groups were compared. Results The time of hospitalization and recovery of body temperature in the observation group were shorter than those in the control group, and the differences were statistically significant （P＜0.05）.There was no significant difference in CRP level between two groups before treatment （P＞0.05）; the CRP level in the observation group was lower than that in the control group after one week of treatment, and the difference was statistically significant （P＜0.05）.The total effective rate in the observation group was 93.0% （40/43）, which was higher than 75.6% （31/41） in the control group （χ2=4.87, P＜0.05）.In the observation group, there was one case of facial flushand and two cases of mild euphoria, but no obvious adverse reactions were observed.In the control group, there was no significant facial flush and euphoria, and the difference between the two groups was not statistically significant （χ2=2.97, P＞0.05）. Conclusion Lowdose Methylprednisolone combined with Azithromycin in the treatment of children with RMPP can effectively shorten the recovery time of body temperature and improve the effect without obvious adverse reactions.Therefore, it is recommended to use in children with RMPP.
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