title: Effects of Methylprednisolone Pulse Therapy on Refractory Mycoplasma pneumoniae Pneumonia in Children.
abstract: OBJECTIVE
  Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community-acquired pneumonia in children. The clinical course is typically self-limited and benign; however, rare cases of severe pneumonia can develop despite appropriate antibiotic therapy. We studied the effects of methylprednisolone pulse therapy on severe refractory M. pneumoniae pneumonia in children.
  
  
  METHODS
  The clinical effects of methylprednisolone therapy were evaluated retrospectively in 12 children with severe refractory M. pneumoniae pneumonia, which was diagnosed serologically. All patients developed respiratory distress, high fever, and initial lobar pneumonic consolidation based on radiological findings. All clinical symptoms deteriorated despite appropriate antibiotic therapy. Thus, children were treated with intravenous methylprednisolone pulse therapy in addition to antibiotics.
  
  
  RESULTS
  The average febrile period before admission was 4.9±1.7 days, and fever persisted in all children until steroid administration. Methylprednisolone pulse therapy (30 mg/kg) was given 5.4±2.5 days after admission. After methylprednisolone pulse therapy, clinical symptoms improved in all patients without adverse events. The fever subsided 0-2 h after initiation of corticosteroid therapy. The abnormal radiological findings resolved within 2.6±1.3 days, and the high C-reactive protein levels (6.7±5.9 mg/dL) on admission decreased to 1.3±1.7 mg/dL within 3.0±1.1 days after starting corticosteroid therapy.
  
  
  CONCLUSIONS
  Three-day methylprednisolone pulse therapy could be applied to treatment of refractory M. pneumoniae pneumonia despite appropriate antibiotic therapy and appeared to be efficacious and well-tolerated.
authors.affiliation: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: You
authors.affiliation: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hye Jeong
authors.initials: HJ
authors.lastname: Jwa
authors.affiliation: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Eun Ae
authors.initials: EA
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hong Ryang
authors.initials: HR
authors.lastname: Kil
authors.affiliation: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
keywords: Children; Mycoplasma pneumoniae; methylprednisolone; pneumonia