{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:44Z","timestamp":1786978304423,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Investigation"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>\n                      Although macrolides combined with glucocorticoid therapy have demonstrated efficacy in preventing long\u2010term pulmonary lesions of severe\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP), evidence regarding glucocorticoid dose is lacking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of low\u2010 and high\u2010dose methylprednisolone on the risk of long\u2010term pulmonary lesions for children with severe MPP when combined with azithromycin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized, parallel\u2010controlled, multicenter clinical trial was conducted in mainland China and enrolled pediatric patients hospitalized with severe MPP. A total of 424 enrolled patients were randomized (allocation ratio of 1:1) to azithromycin combined with either a low\u2010dose [2 mg\/(kg\u00b7d)] or a high\u2010dose [10 mg\/(kg\u00b7d)] methylprednisolone treatment for 3 d followed by tapering over 12 d. The primary outcome was the incidence of composite adverse outcomes, including atelectasis, bronchiectasis, or bronchiolitis obliterans 6 months after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 118 (27.8%) developed adverse pulmonary lesions at 6 months after treatment; 66 of 211 (31.3%) in the high\u2010dose methylprednisolone group and 52 of 213 (24.4%) in the low\u2010dose group, respectively. The risk ratio of long\u2010term pulmonary lesions in a high\u2010dose group to those in a low\u2010dose group was 1.28 (95% confidence interval [95% CI]: 0.94\u20131.75). In addition, the risk of hypertension in the high\u2010dose group (8.1%, 17 of 211) was higher than that in the low\u2010dose group (1.4%, three of 213), with a risk ratio of 5.72 (95% CI: 1.70\u201319.23)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Azithromycin combined with low\u2010dose methylprednisolone demonstrates non\u2010inferior efficacy in reducing pulmonary lesions at 6\u2010month follow\u2010up compared to combined with high\u2010dose methylprednisolone while exhibiting a more favorable safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ped4.70014","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:34:51Z","timestamp":1753367691000},"page":"251-261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Low\u2010dose versus high\u2010dose methylprednisolone for children with severe\n                    <i>Mycoplasma pneumoniae<\/i>\n                    pneumonia (MCMP): A randomized controlled trial"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7157-8078","authenticated-orcid":false,"given":"Baoping","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Respiratory Disease Beijing Children's Hospital, Capital Medical University China National Clinical Research Center of Respiratory Diseases National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Capital Center for Children's Health Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxiao","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Shengjing Hospital of China Medical University  Liaoning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Respiratory department Shanxi Children's Hospital  Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7652-7456","authenticated-orcid":false,"given":"Liwei","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Beijing Children's Hospital, Capital Medical University China National Clinical Research Center of Respiratory Diseases National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Beijing Children's Hospital, Capital Medical University China National Clinical Research Center of Respiratory Diseases National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Beijing Children's Hospital, Capital Medical University China National Clinical Research Center of Respiratory Diseases National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohua","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Center for Clinical Epidemiology &amp; Evidence\u2010based Medicine Beijing Children's Hospital, Capital Medical University National Center for Children's Health  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Capital Center for Children's Health Capital Medical University  Beijing 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