Abstract
OBJECTIVE: To evaluate the clinical outcomes of adjunctive budesonide (BUD) therapy combined with azithromycin (AZM) in pediatric patients diagnosed with Mycoplasma pneumoniae pneumonia (MPP). METHODS: This retrospective cohort analysis examined 120 pediatric MPP cases. Participants were stratified into either a control group (n=55, standard AZM treatment) or an observation group (n=65, AZM in combination with BUD) based on their treatment regimen. Comprehensive assessments included treatment efficacy, safety profiles, resolution of clinical manifestations, serum immunoglobulins, serum inflammatory markers, quality of life, and parental satisfaction. Additionally, univariate and multivariate logistic regression analyses were employed to identify independent predictors for therapeutic response. RESULTS: The observation group exhibited a significantly superior clinical response rate, improved quality of life, and higher parental satisfaction than the control group, with no significant difference in adverse event incidence. Accelerated symptom resolution was observed in the observation group. Furthermore, significant immunomodulatory and anti-inflammatory effects were noted in the observation group. Univariate and multivariate analyses identified four independent predictors for treatment outcomes: disease duration (Odds Ratio [OR]=3.555, 95% Confidence Interval [CI]: 1.123-11.254), pre-treatment IgG levels (OR=0.280, 95% CI: 0.098-0.794), pre-treatment IL-6 levels (OR=3.848, 95% CI: 1.280-11.572), and therapeutic approach (OR=3.517, 95% CI: 1.200-10.304). CONCLUSION: The combination of AZM with BUD demonstrated superior therapeutic outcomes in pediatric MPP management, including accelerated symptom resolution, enhanced immune function, reduced inflammation, and improved quality of life and parental satisfaction, without increasing adverse events.