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Table 1 Characteristics of studies included in the meta-analysis

From: Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials

Study

Characteristics

Intervention

Outcome

 

Country

Year

Number of subjects; mean age of experiment group, y

Number of subjects; mean age of control group

Experimental group

Control group

 

Fan Xuwei 2015 [18]

China

2012–2015

44; 8.2 ± 2.7

43; 7.2 ± 2.1

MPD (2 mg/kg/d) for 5 consecutive days then received 1 mg/kg/d for 2 days

Oral administration of AZM tablets (10 mg/kg; max. dose 0.5 g) for 1 day then received 5 mg/kg of AZM through day 2–5 (max. dose 0.25 g)

Fever duration, Hospital day, CRP change

Feng Xiaoqiang 2016 [26]

China

2013–2015

    

Fever duration, Hospital day, Cough duration, Improvement of chest x-ray

Ji Chaoyu 2017 [28]

China

2014–2016

50; 5.1 ± 0.3

50; 4.9 ± 0.5

IV MPD (2 mg/kg/d) for 3 days

Daily IV infusion of AZM (10 mg/kg/d)

Fever duration, Cough duration

Li Ling 2015 [14]

China

2013–2014

53; 6.5 ± 2.1

51; 6.6 ± 1.9

MPD (2 mg/kg/d) for 3–5 days

Erythromycin IV drip for 1 week, then change to AZM IV drip for 3 days, stop for 4 days, then oral AZM tablets for 3 days, then stop for 4 days then oral AZM tablets for 3 days again, with 3rd generation cephalosporin

Fever duration, Hospital days, Cough duration, Change in chest x-ray, CRP change

Li Ming 2015 [15]

China

2013–2014

50; 3.1 ± 0.4

50; 3.2 ± 0.2

IV administration of prednisolone sodium succinate 1–2 mg/kg/d for 3 days, then changed to oral administration of prednisone 1–2 mg/kg/d, then stopped 7–10 days of tapering

Daily IV administration of AZM (10 mg/kg/d) for 3–5 days, then stopped for 3 days. Sequential therapy with daily administration of AZM dry suspension 10 mg/kg/d for 3 days then stopped for 4 days, and repeated for total course of treatment of 1 month

Fever duration, Hospital days, Cough duration, CRP change

Lin Jianqin 2015 [16]

China

2012–2015

42; 6.4 ± 1.2

41; 6.1 ± 1.3

IV MPD 1 mg/kg/time, 2 times/day, for 3 days, then changed to oral administration of MPD, 1 mg/kg/time, 2 times/day

Daily IV AZM 10 mg/kg, for 3–5 days then oral administration of AZM 10 mg/kg/d for 3 days then stop for 4 days. Oral administration was repeated for 2–3 times during course of treatment

Fever duration, Cough duration, Time to normalization of chest x-ray

Lin Yan 2015 [17]

China

2012–2015

45; 6.4 ± 3.2

45; 6.7 ± 3.3

IV infusion of dexamethasone 0.2–0.3 mg/kg/d for 5 days

IV infusion of AZM and gamma globulin

Fever duration, Hospital day, Cough duration, Time to normalization of chest x-ray, CRP change

Liu Chunyan 2017

China

2015–2016

52; 5.8 ± 4.0

52; 5.6 ± 4.2

IV MPD pulse therapy (1–2 mg/kg/d) for 3 days

IV infusion of immunoglobulin 400 mg/kg/d for 2 days; IV infusion of AZM 10 mg/kg/d for 5 days

Fever duration, Time to normalization of chest x-ray

Liu Qing 2016 [22]

China

2013–2015

74;

62;

IV infusion of MPD 2 mg/kg/d was administered until 24 h after defervescence. Oral prednisone was started with 1–2 mg/kg/d then tapered for 7–14 days

IV infusion of AZM 10 mg/kg/d for 5 days then stop 4 days and repeat for 2–3 cycles

Fever duration

Lu Xiaoyun 2017 [29]

China

2014–2015

53; 6.59 ± 1.57

52; 6.80 ± 1.43

IV infusion of MPD 2 mg/kg/d for 5 days

10 mg/kg of oral AZM for 1 day continued by 5 mg/kg of AZM from day 2–5.

Fever duration, Cough duration, Time to normalization of chest x-ray, CRP change

Qiu Haiyan 2017

China

2015–2016

50; 6.91 ± 2.16

50; 6.85 ± 2.10

MPD 1–2 mg/kg/d

IV AZM (10 mg/kg/d) was used until symptom improvement then changed to daily oral AZM suspension 10 mg/kg/d

Fever duration, Cough duration, CRP change

Ren Mingxing 2015

China

2011–2013

33; 8.9 ± 2.4

34; 9.3 ± 3.0

MPD 2 mg/kg/d for 5 days then reduced to 1 mg/kg/d for 2 days

IV infusion of aspartate AZM 10 mg/kg/d for 3 days; daily IV infusion of gamma globulin 1.5 g/kg for 3 days; IV infusion of rifampicin 10 mg/kg/d for 3 days then stopped for 4 days then change to oral administration of AZM 10 mg/kg/d for 3 days then stopped for 4 days. Total duration of treatment was 7 days for one course of treatment and was continued for 3 weeks

Fever duration, Hospital days, CRP change

Shan Li-Shen 2017 [35]

China

2013–2015

52; 7.36 ± 2.33

50; 7.29 ± 3.03

Oral or IV MPD 2 mg/kg/d for 3 days

IV AZM

Fever duration, CRP change, LDH change, D-dimer change

Shao Xiaoli 2011 [12]

China

2008–2010

38; 6.37 ± 2.83

38; 6.87 ± 2.86

Small dose of MPD for 3–4 weeks

Macrolide antibiotics

Fever duration, Hospital days, Cough duration, Chest X-ray change

Tao Xuyun 2015

China

2013–2014

75; 7.4 ± 1.4

75; 7.3 ± 1.3

IV MPD 2 mg/kg/d for 4–5 days then on 5–7 day of treatment, dose increased to 4 mg/kg/d according to patient symptoms. Then reduced to 1 mg/kg/d for 3 days after defervescence.

IV AZM (10 mg/kg/d) for 3 days then stopped for 4 days. Followed by oral AZM for 3 days then stopped for 4 days continued for 3 weeks with ceftazidime

Fever duration, Hospital day, Cough duration, Change in chest X-ray, CRP change

Wang Hao 2016 [24]

China

2013–2015

40; 5.10 ± 1.86

40; 4.86 ± 1.35

4 consecutive days with 2 mg/kg/d of MPD then reduced to 1 mg/kg/d

Daily IV infusion of AZM 10 mg/kg/d for 3 days. Then changed to 5 mg/kg/d of oral AZM, 3 times/day, for 3 days then stopped for 4 days

Fever duration, Hospital day, CRP change

Wen Jianjun 2016 [23]

China

 

65; 7.1 ± 4.5

65; 7.7 ± 4.5

IV infusion of MPD (2 mg/d, 1–2 times) and reduced as symptoms improved

IV AZM 10 mg/kg/d for 3 days then stopped for 4 days. Changed to oral AZM after symptoms improve

Fever duration, Hospital days

Wu Yourong 2017 [33]

China

2013–2014

  

MPD 2 mg/kg/d for 3 days. Then changed to 1 mg/kg/d for 2 days

IV infusion of AZM 10 mg/kg/d for 3 days. After 3 consecutive days of treatment, oral AZM (10 mg/kg/d) was administered for 3 days then stopped for 4 days

Fever duration, Hospital days

Xu Jiali 2017

China

2015–2017

60; 6.8 ± 1.6

60; 7.1 ± 2.5

Oral intake of MPD (2 mg/kg/d) for 3–5 days on 2nd day of treatment

Daily oral intake of AZM 10 mg/kg/d for 3 days then stopped for 4 days then repeated for 3–4 times

Fever duration, Hospital days, Cough duration, CRP change

Yang Lijun 2015 [19]

China

2012–2014

20

20

IV administration of MPD (1 mg/kg/d) for 2 weeks

IV infusion of AZM (7–10 mg/kg/d)

Fever duration, Hospital days, Cough duration

Yu Jieming 2017 [32]

China

2014–2015

35; 5.6 ± 2.7

35; 5.7 ± 2.3

IV infusion of MPD (2 mg/kg/d), 2 times/day.

IV infusion of erythromycin 20–30 mg/kg/d, 2 times/d. Change to oral AZM (10 mg/kg/d) after 48 h of defervescence

Fever duration, Cough duration, CRP change

Zhang Xiang 2015 [21]

China

2012–2013

32; 5 ± 2

32; 4 ± 1

IV infusion of MPD (1–2 mg/kg/d) with nebulized budesonide, for 3–5 days; If symptoms don’t improve, oral administration of MPD was given for 3–5 days.

IV infusion of erythromycin 20–30 mg/kg/d, for 2 times/day, for 7 days; followed by oral administration of AZM 10 mg/kg/d (max. dose 0.5 g/d), for 3 days then stopped for 4 days

Fever duration, Hospital days

Zhao Shuqing 2017 [34]

China

2013–2015

29; 5.7 ± 2.4

29; 5.3 ± 2.5

Daily IV MPD 1.5–2.0 mg/kg/d for 3 days, then changed to 1 mg/kg/d and tapering within 1 week

IV AZM 10 mg/kg/d on the 1st day, 5 mg/kg/d from 2nd to 5th day, 5 days as a total treatment course

Fever duration, Cough duration, CRP change

Zheng Xuan 2016 [25]

China

2015–2016

70; 5.5 ± 0.5

70; 5.1 ± 0.6

IV infusion of MPD (2 mg/kg/d) for 3 days

IV infusion of AZM (10 mg/kg/d) for 3 days

Fever duration, Cough duration, CRP change

  1. Abbreviations: AZM azithromycin, CRP C-reactive protein, IV intravenous, LDH lactate dehydrogenase, MPD methylprednisolone