High-dose methylprednisolone safe, effective in severe Mycoplasma pneumoniae pneumonia

Treatment with high-dose methylprednisolone is effective against severe Mycoplasma pneumoniae pneumonia (SMPP) and does not increase the incidence of adverse reactions, suggests a study.

“Immunologic mechanisms are thought to play an important role in the pathogenesis of SMPP,” the authors said. “Therefore, the use of systemic glucocorticoids may have beneficial effects.”

This meta-analysis used data from randomized controlled trials (RCTs) of different doses of methylprednisolone in SMPP. The study sought to examine the safety and efficacy of treatment with low compared to high-dose methylprednisolone in children with SMPP.

Thirteen Chinese RCTs that included a total of 1,049 children met the eligibility criteria. The high-dose group comprised 524 children while the low-dose group included 525 participants.

High-dose methylprednisolone was significantly more effective than the low-dose therapy for children with SMPP (risk ratio [RR], 1.30, 95 percent confidence interval [CI], 1.23–1.38; p<0.05). High-dose, compared to low-dose, methylprednisolone also resulted in significantly shortened hospital stays and antipyretic therapy, pulmonary rales disappearance, cough disappearance, and pulmonary shadow absorption times.

In terms of adverse events, no significant difference was noted between the high- and low-dose groups (RR, 0.85, 95 percent CI, 0.53–1.36; p>0.05).

“Mycoplasma pneumoniae pneumonia is generally a self-limiting disease, but it can develop into SMPP,” the authors said. “However, to date, the use of glucocorticoid therapy in SMPP is limited to small case series, and the glucocorticoid dosage for children with SMPP has not been established.”