Objective: To observe the difference of clinical efficacy and safety of dexamethasone vs. methylprednisolone in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 128 children with RMPP were randomly divided into group A (n =63) and group B (n =65). On the basis of conventional treatment

group A was given dexamethasone 0. 35 mg/ (kg·d)

intravenously once a day

and group B was given methylprednisolone 2 mg/ (kg·d)

2 times a day for intravenous drip. Two groups were both treated for 5 days. The clinical efficacy

improvement of clinical symptoms

plasma myocardial enzyme profile such as creatine kinase (CK)

creatine kinase isoenzyme (CK-MB)

lactate dehydrogenase (LDH)

serum inflammatory factors such as tumor necrosis factor-α (TNF-α)

interleukin-6 (IL-6)

and gamma-interferon (IFN-γ) and adverse drug reactions between the two groups were compared. Results: The total effective rate in group B was 86. 15%

which was higher than that in group A (71. 43%) (P< 0. 05). Time that symptoms disappeared of group B was much shorter than that in group A

such as fever (4. 55 ±1. 05) d vs. (5. 24± 1. 12) d

cough (6. 67±1. 12) d vs. (7. 23±1. 57) d

lung rales (10.76±1.47) d vs. (11.63±2.52) d and X-ray lung shadow (7.97± 1. 03) d vs. (8. 43±1. 26) d

and the differences were all statistically significant (all P<0. 05). After treatment

the levels of CK

CK-MB

LDH

TNF-α

IL-6 and IFN-γ of the two groups were all decreased compared with before treatment (P <0. 05)

and the decrease in group B was more significant than that in group A (P<0. 05). The incidence of adverse drug reactions in group A was 22. 22%

which was higher than 9. 23% in group B (P<0. 05). Conclusion: The results of this study show that methylprednisolone is better than dexamethasone in clinical efficacy and safety in children with RMPP.