The literature was screened by the inclusion and exclusion criteria after searching at Cochrane Library, Pubmed, Wanfang, CNKI, and Weipu databases. According to JADAD evaluation system, the relevant information in each included report from the literature was evaluated. The evidence-based analysis was performed for the
therapeutic effects of
macrolides,
glucocorticoid, and
IVIG in treating MP
infections. Meta-analysis was conducted on the suitable literature by RevMan 5.3 software supplied by Cochrane collaboration. Descriptive analysis was conducted on the literature unsuitable for meta-analysis.
RESULT: (1) Seven foreign RCT reports and 7 domestic RCT reports were included in the analysis of the
therapeutic effect of
macrolides. There was a high heterogeneity among the 7 foreign reports. Five of these reports showed no significant difference in clinical effects between
macrolides and non-
macrolide antibacterial agents. The forest plot analysis of
antipyretic timing and
cough duration in the domestic literature with complete indicators suggested that for
azithromycin sequential
therapy vs.
erythromycin intravenous
therapy, the mean difference of
antipyretic timing was-1.10 (95% CI: -1.60,-0.60) and the mean difference of
cough duration was-1.56 (95% CI: -2.10,-1.03). (2) Three foreign RCT reports and 5 domestic RCT were included in the analysis of
glucocorticoid therapy. The JADAD scores of all the reports were 1. The basic
therapy drug was
macrolides. The results of sub-group analysis suggested that for the patients who used
glucocorticoid early vs. the patients who used non-
glucocorticoid therapy, the mean difference of
antipyretic time was-1.77(95% CI: -2.44,-1.10) and the mean difference of
cough duration was-2.47 (95% CI: -2.86,-2.08); for the patients treated with
glucocorticoid at 10 days after onset of diseases vs. the patients received non-
glucocorticoid therapy, the mean difference of
antipyretic time was-3.41 (95% CI: -4.10,-2.73) and the mean difference of
cough duration was-2.25 (95%CI: -4.38,-0.12). (3) Regarding
IVIG, all the included reports were case study or case report. Most of the literature focused on severe
Mycoplasma pneumoniae infection and those with extrapulmonary complications. The limited results suggested a trend of the shortening of disease process and improvement of clinical symptoms by
IVIG.
CONCLUSION: