Comparison of inflammatory control and safety by timing of doxycycline-azithromycin dual therapy in pediatric mycoplasmal pneumonia

The therapeutic approach of combining doxycycline (DOX) with azithromycin (AZM) has emerged as an effective strategy for managing pediatric Mycoplasmal pneumonia (MP), with its clinical efficacy well-established. It is worth noting that both DOX and AZM are antibiotics and require an interval of 24-72 hours when used in combination, but there are few studies on the optimal interval between the two drugs. This study aimed to elucidate the differential outcomes of two treatment regimens. The short-term group received DOX in combination with AZM within 24-72 hours after AZM administration for MP treatment, while the long-term group initiated DOX therapy more than 72 hours after AZM treatment. Our findings indicated that there were no statistically significant differences in clinical efficacy and the impact on pediatric pulmonary function between the two groups (P>0.05). However, the time for symptom improvement in the short-term group was significantly shortened (P<0.05), while the long-term group exhibited lower inflammatory responses, stress responses and a reduced incidence of complications (P<0.05). In conclusion, initiating DOX within 72 hours after AZM treatment can expedite the treatment course of MP, while using DOX more than 72 hours after AZM treatment confers enhanced safety.