{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:05:18Z","timestamp":1790057118801,"version":"4.0.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Objective<\/jats:title>\n To investigate the clinical efficacy of methylprednisolone sodium succinate combined with azithromycin in the treatment of pediatric bronchopneumonia, and to explore its comprehensive effects on immune regulation and inflammation relief.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective controlled study included 120 pediatric patients with bronchopneumonia diagnosed in our hospital from October 2021 to March 2025. According to the treatment regimen, patients were divided into two groups: the experimental group (\n n<\/jats:italic>\n \u2009=\u200960) received methylprednisolone sodium succinate combined with azithromycin on the basis of routine treatment, while the control group (\n n<\/jats:italic>\n \u2009=\u200960) received azithromycin alone on the basis of routine treatment. The efficacy indicators before and after treatment, symptom improvement time (including time to defervescence, disappearance time of cough and sputum, resolution time of pulmonary rales, relief time of wheezing and dyspnea, time to disappearance of abnormal chest imaging, and length of hospital stay), inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-\u03b1 (TNF-\u03b1)] and immune parameters [immunoglobulin A (IgA), IgG, IgM] of the two groups were analyzed, and the adverse drug reactions during treatment were recorded.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with the control group, the overall efficacy of the experimental group was significantly better (total effective rate: 93.3% vs. 80.0%,\n P<\/jats:italic>\n \u2009&lt;\u20090.05). In terms of symptom improvement time, including time to fever resolution, disappearance of cough and sputum, resolution of pulmonary rales, relief of wheezing and dyspnea, disappearance of abnormal chest imaging and length of hospital stay, all indicators were significantly shortened in the experimental group (\n P<\/jats:italic>\n \u2009&lt;\u20090.05). After treatment, IL-6 and TNF-\u03b1 levels were significantly decreased and IgA, IgG, and IgM levels were significantly increased in both groups, with more significant improvements observed in the experimental group (\n P<\/jats:italic>\n \u2009&lt;\u20090.05). The incidence of adverse drug reactions was similar between the two groups (8.3% vs. 13.3%,\n P<\/jats:italic>\n \u2009&gt;\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Methylprednisolone sodium succinate combined with azithromycin can effectively shorten the course of mycoplasma bronchopneumonia in children, improve clinical symptoms, reduce inflammatory responses, and enhance immune responses. Under the premise of ensuring safety, it has advantages over azithromycin alone and has good clinical application prospects.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1842718","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:39:10Z","timestamp":1790055550000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Methylprednisolone sodium succinate combined with azithromycin in the treatment of Mycoplasma pneumonia in children and Its effect on immune function"],"prefix":"10.3389","volume":"14","author":[{"given":"Qingmei","family":"Zhang","sequence":"first","affiliation":[{"name":"NO.215 Hospital of Shaanxi Nuclear Industry","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Hao","sequence":"additional","affiliation":[{"name":"NO.215 Hospital of Shaanxi Nuclear Industry","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Li","sequence":"additional","affiliation":[{"name":"NO.215 Hospital of Shaanxi Nuclear Industry","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"336","DOI":"10.3760\/cma.j.cn112150-20240911-00731","article-title":"Epidemiological characteristics of co-infection with drug-resistant Mycoplasma pneumoniae and non-bacterial pathogens in a children\u2019s hospital in ningbo city from 2021 to 2024","volume":"59","author":"Wang","year":"2025","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.3760\/cma.j.cn112150-20240625-00504","article-title":"Analysis of drug-resistance mutations and treatment of Mycoplasma pneumoniae pneumonia in children in hunan province in 2023","volume":"58","author":"Li","year":"2024","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.3760\/cma.j.cn112338-20220321-00210","article-title":"Clinical characteristics of Mycoplasma pneumoniae infection and factors associated with co-infections in children","volume":"43","author":"Yi","year":"2022","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"B4","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1186\/s13063-024-08438-6","article-title":"A randomized controlled non-inferiority trial of placebo versus macrolide antibiotics for Mycoplasma pneumoniae infection in children with community-acquired pneumonia: trial protocol for the MYTHIC study","volume":"25","author":"Meyer Sauteur","year":"2024","journal-title":"Trials"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.3760\/cma.j.cn112150-20240606-00452","article-title":"A retrospective cohort study based on propensity score matching evaluating the effect of bronchoalveolar lavage on the clinical prognosis of children with macrolide-resistant Mycoplasma pneumoniae pneumonia","volume":"58","author":"Wu","year":"2024","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.3760\/cma.j.cn112150-20240617-00478","article-title":"The levels and clinical significance of serum miR-146a, miR-145, and Th17\/treg in children with respiratory syncytial virus pneumonia","volume":"58","author":"Qu","year":"2024","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B7","doi-asserted-by":"publisher","first-page":"99576","DOI":"10.4239\/wjd.v16.i5.99576","article-title":"Therapeutic effectiveness of intratympanic and retroauricular methylprednisolone sodium succinate for refractory sudden sensorineural hearing loss in diabetic patients","volume":"16","author":"Li","year":"2025","journal-title":"World J Diabetes"},{"key":"B8","doi-asserted-by":"publisher","first-page":"152351","DOI":"10.1016\/j.semarthrit.2023.152351","article-title":"Effectiveness and safety of a 26-week taper regimen of glucocorticoid in patients with giant cell arteritis: results from a prospective cohort study","volume":"64","author":"Muratore","year":"2024","journal-title":"Semin Arthritis Rheum"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0281585","DOI":"10.1371\/journal.pone.0281585","article-title":"Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: study protocol of the randomized controlled TOASST (taper or abrupt steroid STop) multicenter trial","volume":"18","author":"Komminoth","year":"2023","journal-title":"PLoS One"},{"key":"B10","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3760\/cma.j.cn112150-20241212-01000","article-title":"Epidemiology, clinical characteristics, and risk factors of severe rhinovirus-associated pneumonia in children","volume":"59","author":"Zhang","year":"2025","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B11","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3760\/cma.j.cn112150-20240819-00672","article-title":"Analysis of Mycoplasma pneumoniae antibody detection data from a hospital in Beijing city from 2017 to 2024","volume":"59","author":"Yan","year":"2025","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B12","doi-asserted-by":"publisher","first-page":"592","DOI":"10.3760\/cma.j.cn121430-20210223-00273","article-title":"Value of dynamic changes in serum amyloid protein for evaluating the condition and prognosis of patients with community-acquired pneumonia caused by viruses and Mycoplasma","volume":"34","author":"Ma","year":"2022","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"B13","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3760\/cma.j.cn112147-20200803-00870","article-title":"Focus on the difficulties and challenges in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia","volume":"44","author":"She","year":"2021","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"B14","doi-asserted-by":"publisher","first-page":"861","DOI":"10.3760\/cma.j.cn112140-20240417-00272","article-title":"Clinical features and predictive factors of plastic bronchitis in children with severe Mycoplasma pneumoniae pneumonia","volume":"62","author":"Mu","year":"2024","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"B15","doi-asserted-by":"publisher","first-page":"696","DOI":"10.3760\/cma.j.cn112140-20240407-00247","article-title":"Advancement in epidemiology of Mycoplasma pneumoniae pneumonia in children in China","volume":"62","author":"Liu","year":"2024","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.7499\/j.issn.1008-8830.2406089","article-title":"Efficacy of prolonged azithromycin therapy versus switching to doxycycline in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia","volume":"26","author":"Ma","year":"2024","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"B17","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3881\/j.issn.1000-503X.13399","article-title":"Application of methylprednisolone sodium succinate combined with tropisetron in the prevention of nausea and vomiting during microvascular decompression for hemifacial spasm","volume":"43","author":"Wang","year":"2021","journal-title":"Zhongguo Yi Xue Ke Xue Yuan Xue Bao"},{"key":"B18","doi-asserted-by":"publisher","first-page":"6128","DOI":"10.19540\/j.cnki.cjcmm.20230815.701","article-title":"Characteristic changes of blood stasis syndrome in a rat model of steroid-induced femoral head necrosis based on the combination of disease, syndrome, and symptoms","volume":"48","author":"Hu","year":"2023","journal-title":"Zhongguo Zhong Yao Za Zhi"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.19540\/j.cnki.cjcmm.20211116.401","article-title":"Effect of jianpi huogu formula on functional damage of vascular endothelial cells induced by glucocorticoids","volume":"47","author":"Xu","year":"2022","journal-title":"Zhongguo Zhong Yao Za Zhi"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1002\/adbi.202300098","article-title":"Single-cell sequencing reveals the optimal time window for anti-inflammatory treatment in spinal cord injury","author":"Ye","year":"2023","journal-title":"Adv Biol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.medcli.2022.02.025","article-title":"Predicting the response to methylprednisolone pulses in patients with SARS-CoV-2 infection","volume":"159","author":"Sarri\u00e1-Landete","year":"2022","journal-title":"Med Clin (Barc)"},{"key":"B22","first-page":"2447","article-title":"Effects of a combination of erythromycin sequential therapy and azithromycin on lung function and inflammatory factors in children with severe Mycoplasma pneumonia","volume":"34","author":"Wang","year":"2021","journal-title":"Pak J Pharm Sci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1002\/ppul.26907","article-title":"Age-related effects of Mycoplasma pneumoniae infection and subsequent asthma exacerbation in children","volume":"59","author":"Ha","year":"2024","journal-title":"Pediatr Pulmonol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.3760\/cma.j.cn112150-20230210-00094","article-title":"Serum immunoglobulin concentrations and the risk of type 2 diabetes mellitus in adults in Tianjin city: a prospective cohort study","volume":"57","author":"Jin","year":"2023","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"B25","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1089\/vim.2022.0002","article-title":"Dysfunctional state of T cells or exhaustion during chronic viral infections and COVID-19: a review","volume":"35","author":"Mishra","year":"2022","journal-title":"Viral Immunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/j.pt.2019.08.007","article-title":"Critical roles of endogenous glucocorticoids for disease tolerance in malaria","volume":"35","author":"Vandermosten","year":"2019","journal-title":"Trends Parasitol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"20182913","DOI":"10.1098\/rspb.2018.2913","article-title":"Exogenous glucocorticoids amplify the costs of infection by reducing resistance and tolerance, but effects are mitigated by co-infection","volume":"286","author":"Schoenle","year":"2019","journal-title":"Proc Biol Sci"},{"key":"B28","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12887-023-04512-1","article-title":"Clinical features of Mycoplasma pneumoniae pneumonia in children without fever","volume":"24","author":"Li","year":"2024","journal-title":"BMC Pediatr"},{"key":"B29","doi-asserted-by":"publisher","first-page":"11626","DOI":"10.1021\/acsnano.3c02075","article-title":"An inhalable hybrid biomimetic nanoplatform for sequential drug release and remodeling lung immune homeostasis in acute lung injury treatment","volume":"17","author":"Liu","year":"2023","journal-title":"ACS Nano"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.3760\/cma.j.cn121430-20220628-00508","article-title":"Digoxin alleviates pulmonary fibrosis by regulating phosphatidylinositol-3-kinase\/akt signaling through inhibiting fibroblast activation: an in vivo and in vitro experiment","volume":"34","author":"Jia","year":"2022","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"B31","doi-asserted-by":"publisher","first-page":"3046","DOI":"10.21037\/tp-21-461","article-title":"Efficacy and safety of glucocorticoids in the treatment of progressive muscular dystrophy in children: a systematic review and meta-analysis","volume":"10","author":"Ru","year":"2021","journal-title":"Transl Pediatr"},{"key":"B32","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/INF.0000000000002529","article-title":"Meta-analysis of the clinical efficacy and safety of high- and low-dose methylprednisolone in the treatment of children with severe Mycoplasma pneumoniae pneumonia","volume":"39","author":"Sun","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e20121","DOI":"10.1097\/MD.0000000000020121","article-title":"Efficacy and safety of azithromycin combined with glucocorticoid on refractory Mycoplasma pneumoniae pneumonia in children: a PRISMA-compliant systematic review and meta-analysis","volume":"99","author":"Qiu","year":"2020","journal-title":"Medicine (Baltimore)"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1842718\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:39:23Z","timestamp":1790055563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1842718\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":33,"alternative-id":["10.3389\/fped.2026.1842718"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1842718","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"1842718"}}