{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:03:43Z","timestamp":1789625023500,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"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":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory infection in children. With the increasing prevalence of macrolide-resistant strains, minocycline has become a crucial alternative treatment. However, there is a lack of early predictive markers for evaluating early clinical response. This study aimed to investigate the clinical value of the neutrophil-to-lymphocyte ratio (NLR) and D-dimer levels in predicting early clinical response to minocycline in pediatric MPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 86 children aged 8\u201314 years with MPP who received minocycline treatment at Tianjin University Central Hospital between January 2023 and January 2025. Treatment efficacy was defined based on the body temperature response within 48\u2005h after initiating minocycline: patients whose body temperature returned to normal (\u226437.3\u2005\u00b0C) were classified as having effective treatment (responsive group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951), whereas those with persistent fever requiring the addition of systemic corticosteroids (methylprednisolone) were classified as having ineffective treatment (non-responsive group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935). Baseline NLR and D-dimer levels, along with other laboratory indicators obtained prior to treatment, were compared between the two groups to evaluate their predictive value for treatment outcome. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The non-responsive group exhibited significantly higher NLR (median 2.62 vs. 1.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and D-dimer levels (median 0.36 vs. 0.18\u2005mg\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) compared to the responsive group. Multivariate logistic regression identified NLR (OR=2.113, 95% CI: 1.184\u20133.770,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.011) and D-dimer (OR\u2009=\u2009148.867, 95% CI: 4.994\u20134438.007,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) as independent risk factors for poor treatment response. ROC analysis demonstrated that the area under the curve (AUC) for the combined detection of NLR and D-dimer was 0.858 (95% CI: 0.756\u20130.926), which was superior to NLR (AUC=0.773) or D-dimer (AUC=0.776) alone. Optimal cut-off values were determined as 1.904 for NLR (sensitivity 82.9%, specificity 76.7%) and 0.175\u2005mg\/L for D-dimer (sensitivity 94.3%, specificity 89.5%). Furthermore, both NLR and D-dimer were positively correlated with the length of hospital stay (r\u2009=\u20090.383 and r\u2009=\u20090.477, respectively,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NLR and D-dimer are reliable and accessible biomarkers for predicting early clinical response to minocycline in pediatric MPP. Elevated baseline levels identify patients at risk for persistent fever and need for treatment escalation. Their combined detection offers high clinical value, facilitating early identification of poor responders and timely adjustment of therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1865687","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:31:55Z","timestamp":1789623115000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical value of neutrophil-to-lymphocyte ratio and D-dimer in predicting the efficacy of minocycline for pediatric Mycoplasma pneumoniae pneumonia"],"prefix":"10.3389","volume":"14","author":[{"given":"Rui Fang","family":"Chen","sequence":"first","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Jiang","sequence":"additional","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XinYing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"QianYu","family":"Zhai","sequence":"additional","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JunLi","family":"Wang","sequence":"additional","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Feng","sequence":"additional","affiliation":[{"name":"Tianjin Third Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among U.S","volume":"372","author":"Jain","year":"2015","journal-title":"children. 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