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Combined treatment with glucocorticoids can improve this outcome, though the optimal dosage is unknown. The aim of this study was to investigate the effects of low\u2010 and high\u2010dose methylprednisolone in reducing the percentage of long\u2010term pulmonary outcomes for children with severe <jats:styled-content style=\"fixed-case\">MPP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized, single\u2010blind, parallel\u2010controlled, multicenter clinical trial, methylprednisolone for children with severe <jats:italic>M. pneumoniae<\/jats:italic> pneumonia (<jats:styled-content style=\"fixed-case\">MCMP<\/jats:styled-content>), is being conducted in China. Pediatric patients (\u226418 years of age, expected number = 402) admitted to the hospital with a clinical diagnosis of severe <jats:styled-content style=\"fixed-case\">MPP<\/jats:styled-content> and fulfilling inclusion and exclusion criteria are randomized (ratio of 1:1) to either a low\u2010dose (2 mg\/kg\/d) or high\u2010dose (10 mg\/kg\/d) methylprednisolone treatment group for 3 days followed by tapering of methylprednisolone over 12 days and combined with azithromycin. The primary composite outcome will be incidence of atelectasis, bronchiectasis, or bronchiolitis obliterans at 6\u2010months after treatment. Secondary outcomes include recovery time of patient temperature, proportion of pulmonary lesions absorbed, changes of mucosa identified by bronchoscopy, length of hospital stay, pulmonary function and number of participant(s) needing intensive care. Assessments will be made at baseline, post\u2010treatment and at 1\u2010month, 3\u2010month and 6\u2010month follow\u2010ups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This is the first randomized clinical trial designed to evaluate the safety and efficacy of low\u2010 versus high\u2010dose methylprednisolone for reducing long\u2010term pulmonary outcomes in pediatric patients with severe <jats:styled-content style=\"fixed-case\">MPP<\/jats:styled-content>. The results of this study will provide scientific evidence to guide clinical practice for the treatment of severe <jats:styled-content style=\"fixed-case\">MPP<\/jats:styled-content>. Trial registration: This study is registered at ClinicalTrials.gov (<jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>02303587).<\/jats:p><\/jats:sec>","DOI":"10.1002\/ped4.12041","type":"journal-article","created":{"date-parts":[[2018,10,18]],"date-time":"2018-10-18T03:30:42Z","timestamp":1539833442000},"page":"176-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Low\u2010dose versus high\u2010dose methylprednisolone for children with severe <i>Mycoplasma pneumoniae<\/i> pneumonia (<scp>MCMP<\/scp>): Study protocol for a randomized controlled trial"],"prefix":"10.1002","volume":"2","author":[{"given":"Baoping","family":"Xu","sequence":"first","affiliation":[{"name":"China National Clinical Research Center for Respiratory Diseases Department of Respiratory Medicine Beijing Children's Hospital Capital Medical University, National Center for Children's Health Beijing 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