Effectiveness of Azithromycin Combined with Intravenous Immunoglobulin for Treating Refractory Mycoplasma pneumoniae Pneumonia in Children

The incidence of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children is on the rise, presenting a significant risk to life. Intravenous immunoglobulin (IVIG) has been shown to modulate the immune system and may be effective in treating RMPP. This study conducted a meta-analysis to assess the clinical efficacy and safety of combining azithromycin with IVIG for treating RMPP in children.

A comprehensive search across seven databases, including PubMed and the Cochrane Library, identified studies on treating refractory Mycoplasma pneumoniae pneumonia (RMPP) in children with azithromycin combined with intravenous immunoglobulin (IVIG). Meta-analysis and sensitivity analysis were performed to assess the results' heterogeneity and stability. A total of thirteen randomized controlled trials and two cohort studies were included, encompassing 1,142 children.

The meta-analysis results indicated a higher clinical efficacy rate (RR = 1.18, 95% CI: 1.11–1.25) and shorter durations for defervescence (MD = -2.12, 95% CI: -2.69–-1.55), disappearance of pulmonary rales (MD = -2.90, 95% CI: -3.57–-2.23), resolution of cough (MD = -3.59, 95% CI: -4.51–-2.67), and hospital length of stay (MD = -5.72, 95% CI: -8.80–-2.64) in the experimental group receiving azithromycin combined with IVIG compared to the control group treated with azithromycin alone. Furthermore, no significant publication bias was detected in this meta-analysis.

To conclude, the combination of azithromycin and IVIG is more effective than using azithromycin alone for treating children with RMPP.

Source: Shen YY, Feng ZQ, Wang ZP, Wang XQ, Luo C, Liu QZ. Efficacy of azithromycin combined with intravenous immunoglobulin in the treatment of refractory mycoplasma pneumoniae pneumonia in children: a meta-analysis. BMC Pediatr. 2024 Oct 25;24(1):678. doi: 10.1186/s12887-024-05150-x. PMID: 39455988; PMCID: PMC11515308.