azithromycin + doxycycline + prednisone

azithromycin + doxycycline + prednisone is a combination therapeutic regimen being evaluated by the Children's Hospital of Hebei Province for the treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in pediatric patients. This regimen employs a sequential and guided approach to address both macrolide-resistant *Mycoplasma pneumoniae* and the associated hyperinflammatory response. Azithromycin serves as the primary antibiotic, while doxycycline is introduced as a secondary agent targeting the 30S ribosomal subunit in cases of confirmed macrolide resistance. Prednisone, a corticosteroid, is integrated into the protocol as an immunomodulatory agent, with its use specifically guided by the analysis of monocyte subsets (specifically intermediate monocytes >15%) to mitigate lung injury. This multi-modal strategy aims to improve clinical outcomes, such as recovery time and recurrence rates, by personalizing therapy through diagnostic tools like bronchoscopy and CT scoring.