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. 2023 Jul 8;49(1):80.
doi: 10.1186/s13052-023-01491-y.

Acetylcysteine and budesonide for the treatment of refractory Mycoplasma pneumoniae pneumonia in children: a clinical observation

Yanli Wang  1 , Kai Liu  2   3 , Chuangui Chen  1 , Chengyun Zhang  4
Affiliations

Acetylcysteine and budesonide for the treatment of refractory Mycoplasma pneumoniae pneumonia in children: a clinical observation

Yanli Wang et al. Ital J Pediatr. .

Abstract

Background: To examine the clinical impact of bronchoscope alveolar lavage (BAL) combination with budesonide, ambroxol + budesonide, or acetylcysteine + budesonide in the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP).

Methods: Eighty-two RMPP patients admitted to Pediatrics at The First People's Hospital of Zhengzhou were retrospectively evaluated between August 2016 and August 2019. All patients were administered BAL in addition to intravenous Azithromycin, expectoration, and nebulizer inhalation. The medications added to the BLA separated the patients into the Budesonide group, Ambroxol + budesonide group, and acetylcysteine + budesonide group. Analyzed were the variations in laboratory examination indices, improvement in lung imaging, overall effective rate, and adverse responses in the three groups.

Results: The laboratory test indices of patients in all three groups improved significantly relative to pre-treatment levels, and the results were statistically significant. After therapy, there were no significant differences between the three groups in terms of white blood cell (WBC), C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR). Serum lactate dehydrogenase (LDH) and serum ferritin (SF) varied significantly across the three groups (P < 0.05). In the acetylcysteine + budesonide group, the absorption rate of lung imaging lesions and clinical efficacy were superior to those of the other two groups. There were no significant differences between the three groups in the occurrence of adverse events (P > 0.05).

Conclusions: BLA-coupled acetylcysteine + budesonide was superior to the other two groups in enhancing the effectiveness of RMPP in children, which might increase lung opacity absorption and minimize lung inflammation.

Keywords: Acetylcysteine; Bronchoscopic alveolar lavage; Children; Refractory Mycoplasma pneumoniae pneumonia.

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Conflict of interest statement

The authors declare that there are no competing financial interests related to this work.

Figures

Fig. 1
Fig. 1
The right main airway was completely
Fig. 2
Fig. 2
A mucous discharge originating from one branch of the bronchus
Fig. 3
Fig. 3
Sputum embolus
Fig. 4
Fig. 4
Sputum embolus was removed
Fig. 5
Fig. 5
The mucosa of the bronchial wall was edema and stenosis
Fig. 6
Fig. 6
Sputum embolus
Fig. 7
Fig. 7
Pneumothorax lobar pneumonia
Fig. 8
Fig. 8
Pleuraleffusion Atelectasis
See this image and copyright information in PMC

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