Impact of early corticosteroid therapy on short-term pulmonary function and clinical outcomes in children with severe Mycoplasma pneumoniae pneumonia.

BACKGROUND: Severe Mycoplasma pneumoniae pneumonia (SMPP) in children can lead to pulmonary function impairment. This study aimed to evaluate the impact of early corticosteroid therapy combined with antibiotics versus antibiotics alone on short-term pulmonary function and clinical outcomes in children diagnosed with SMPP. METHODS: A retrospective analysis was performed on 259 pediatric inpatients diagnosed with SMPP at our hospital between October 2022 and June 2025. Patients were divided into the antibiotics alone group (n = 158) and the early corticosteroid use group (n = 101). Pulmonary function, such as peak expiratory flow (PEF), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and small airway function parameters were measured before and after treatment. We also assessed injury markers-including lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT)-as well as inflammatory cytokines (C-reactive protein [CRP], interleukin-6 [IL-6], and interferon-gamma [IFN-γ]) and immunoglobulins (IgA, IgG, IgM). Clinical symptom resolution times and adverse reactions were compared. RESULTS: After treatment, the early corticosteroid group showed significantly higher PEF (5.74 ± 0.57 vs. 5.13 ± 0.65 L/s), FEV1 (2.81 ± 0.35 vs. 2.38 ± 0.33 L), and FVC (3.22 ± 0.44 vs. 2.75 ± 0.41 L), along with better small airway function compared to the antibiotics alone group (all P < 0.05). The corticosteroid group also exhibited notably lower levels of LDH (398.62 ± 105.43 vs. 492.36 ± 118.74 U/L), CRP (7.62 ± 2.14 vs. 12.35 ± 3.28 mg/L), and IL-6 (14.28 ± 4.53 vs. 24.51 ± 6.75 pg/mL), and higher immunoglobulin levels (all P < 0.05). Times to cough disappearance, defervescence, and hospitalization were notably shorter in the corticosteroid group (all P < 0.05). CONCLUSION: Early corticosteroid use combined with antibiotics was associated with significantly greater short-term improvement in pulmonary function, reduced inflammatory markers, and faster clinical symptom resolution in children with SMPP.