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Yuan Cheng, Qing-Feng Fang, Bi-Quan Chen Department of Infectious Diseases, Anhui Provincial Children’s Hospital, Hefei, Anhui, 230022, People’s Republic of ChinaCorrespondence: Bi-Quan Chen, Email chengyi579593@163.comObjective: To analyze the clinical efficacy of azithromycin in the treatment of pediatric Mycoplasma pneumoniae pneumonia and its impact on platelet count and D-dimer levels.Methods: A comparison was made between the two groups regarding clinical treatment effects, recovery status, levels of blood indicators [C-reactive protein (CRP), white blood cell count (WBC), platelet count (PLT), D-dimer (D-D)], and the occurrence of adverse reactions. The control group received conventional symptomatic treatment, while the case group received both conventional treatment and azithromycin.Results: ① Clinical treatment effects: The total effective rate of treatment in the control group was 84.21%, while it was significantly higher at 96.83% in the case group (P < 0.05). ② Recovery status: After treatment, the case group exhibited significantly shorter durations for fever clearance, cough disappearance, rale disappearance, resolution of chest radiographic shadows, and hospital stay compared to the control group (P < 0.05). ③ Blood indicator levels: After treatment, the levels of C-reactive protein (CRP), white blood cell count (WBC), platelet count (PLT), and D-dimer (D-D) were significantly lower in the case group than in the control group, indicating an improvement in the inflammatory response and blood clotting status.Conclusion: Addition of azithromycin to conventional symptomatic treatment significantly improves the efficacy of Mycoplasma pneumoniae pneumonia treatment in children, reduces inflammatory response, improves blood circulation, further promotes recovery without a substantial increase in related adverse reactions, suggesting its relatively high safety in clinical application and advocating for its clinical promotion.Keywords: azithromycin, pediatric Mycoplasma pneumoniae pneumonia, clinical efficacy, platelet count, D-dimer

ObjectiveThe purpose of this study is to evaluate the efficacy of Vitamin A (VitA) as an adjuvant therapy for pediatric Mycoplasma Pneumoniae Pneumonia (MPP) through meta-analysis, and to investigate its impact on inflammation levels (IL-6, IL-10), in order to explore the role of VitA in pediatric MPP.MethodsUsing a systematic literature search method, relevant research literature is searched, and RCT studies that meet the requirements are selected based on preset inclusion and exclusion criteria. Then, a quality evaluation was conducted on the included literature, and meta-analysis was used to calculate the combined effect values of mortality rate, hospital stay, lung rale disappearance time, cough duration, fever duration, IL-6 and IL-10 levels, and heterogeneity analysis was conducted. The levels of IL-6 and IL-10 represent the inflammatory levels in pediatric MPP patients, and exploring their changes has significant implications for the anti-inflammatory effect of treatment.ResultsA total of 10 RCT studies were included, with a total sample size of 1,485, including 750 cases in the control group and 735 cases in the observation group. The meta-analysis results of this study showed that there was a significant difference in the total clinical efficacy of using VitA adjuvant therapy compared to the control group without VitA [OR = 3.07, 95%CI = (2.81, 4.27)], P 0.05. At the same time, the hospitalization time [MSD = −0.86, 95% CI = (−1.61, −0.21)], lung rale disappearance time [MSD = −0.78, 95%CI = (−1.19,−0.51)], cough duration [MSD = −1.07, 95%CI = (−1.41, −0.71)], and fever duration [MSD = −0.47, 95%CI = (−0.72, −0.23)] using VitA as an adjuvant treatment were obviously lower. In addition, the meta-analysis outcomes also showed that the use of VitA adjuvant therapy can significantly reduce IL-6 [MSD = −1.07, 95%CI = (−1.81, −0.27)] and IL-10 [MSD = −0.13, 95%CI = (−0.31, 0.12)] levels. This indicates that the application of VitA in pediatric MPP also has the effect of reducing inflammatory response.ConclusionBased on the meta-analysis results, VitA adjuvant therapy can significantly improve the clinical symptoms of pediatric MPP patients, shorten hospitalization time, promote the disappearance of lung rales, and alleviate cough and fever symptoms. In addition, VitA adjuvant therapy can effectively reduce inflammation levels, indicating its potential role in inhibiting inflammatory responses. In clinical practice, VitA adjuvant therapy for pediatric MPP can be promoted as a potential treatment option.

Objective: The purpose of this study is to evaluate the efficacy of Vitamin A (VitA) as an adjuvant therapy for pediatric Mycoplasma Pneumoniae Pneumonia (MPP) through meta-analysis, and to investigate its impact on inflammation levels (IL-6, IL-10), in order to explore the role of VitA in pediatric MPP., Methods: Using a systematic literature search method, relevant research literature is searched, and RCT studies that meet the requirements are selected based on preset inclusion and exclusion criteria. Then, a quality evaluation was conducted on the included literature, and meta-analysis was used to calculate the combined effect values of mortality rate, hospital stay, lung rale disappearance time, cough duration, fever duration, IL-6 and IL-10 levels, and heterogeneity analysis was conducted. The levels of IL-6 and IL-10 represent the inflammatory levels in pediatric MPP patients, and exploring their changes has significant implications for the anti-inflammatory effect of treatment., Results: A total of 10 RCT studies were included, with a total sample size of 1,485, including 750 cases in the control group and 735 cases in the observation group. The meta-analysis results of this study showed that there was a significant difference in the total clinical efficacy of using VitA adjuvant therapy compared to the control group without VitA [OR = 3.07, 95%CI = (2.81, 4.27)], P  < 0.05. However, there was no significant difference in the adverse reaction rate between the use of VitA as an adjuvant therapy and the control without VitA [OR = 1.17, 95%CI = (0.61, 2.27)], P  > 0.05. At the same time, the hospitalization time [MSD = -0.86, 95% CI = (-1.61, -0.21)], lung rale disappearance time [MSD = -0.78, 95%CI = (-1.19,-0.51)], cough duration [MSD = -1.07, 95%CI = (-1.41, -0.71)], and fever duration [MSD = -0.47, 95%CI = (-0.72, -0.23)] using VitA as an adjuvant treatment were obviously lower. In addition, the meta-analysis outcomes also showed that the use of VitA adjuvant therapy can significantly reduce IL-6 [MSD = -1.07, 95%CI = (-1.81, -0.27)] and IL-10 [MSD = -0.13, 95%CI = (-0.31, 0.12)] levels. This indicates that the application of VitA in pediatric MPP also has the effect of reducing inflammatory response., Conclusion: Based on the meta-analysis results, VitA adjuvant therapy can significantly improve the clinical symptoms of pediatric MPP patients, shorten hospitalization time, promote the disappearance of lung rales, and alleviate cough and fever symptoms. In addition, VitA adjuvant therapy can effectively reduce inflammation levels, indicating its potential role in inhibiting inflammatory responses. In clinical practice, VitA adjuvant therapy for pediatric MPP can be promoted as a potential treatment option., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Cao, Lin, Sheng, Chen and Hu.)