The critical initial markers for steroid therapy in refractory Mycoplasma pneumoniae pneumonia in children

Refractory MP is defined as a case with prolonged fever accompanied by the deterioration of radiological findings despite appropriate treatment with macrolide. We want to clarify biomarker of refractory MP and compared critical initial biomarkers between children with MP responding to macrolide and those with refractory MP. Total of 132 children who were admitted due to pneumonia. The children were divided into 4 groups those with MP who had clarithromycin alone without any documented viral infection (Group I), those with MP who had combination therapy with clarithromycin and dexamethasone without any documented viral infection (Group II) those with MP who had clarithromycin alone with documented viral infection (Group III), those with viral pneumonia without any documented M pneumoniae infection (Group IV). Controls were recruited from the admitted children without documented viral infection and MP. (Group V). We compare levels of cytokines IL-6, IL-17, IL-18 and TNF-α, LDH and ferritin among the study group Serum LDH, IL-17, IL-18, and ferritin concentrations measured at admission were significantly higher in group II than in groups I, III, IV and V . Serum LDH concentration had strong positive correlation with serum ferritin and IL-18, but had weak positive correlation with serum IL-17. There were significant differences identified in LDH, IL-17, IL-18 and Ferritin between pediatric patients with refractory Mp pneumonia and non-refractory Mp pneumonia. It contribute to identify biomarker to indicate refractory Mp pneumonia and its early diagnosis . And such a result will reduce duration of refractory Mp pneumonia.