Taming the Inflammation: The Role of Corticosteroids in Pediatric Mycoplasma Pneumonia

<b>Background/Objectives</b>: To summarize the available evidence on the use of corticosteroids in the treatment of pediatric <i>Mycoplasma pneumoniae</i> pneumonia, including severe and refractory forms. <b>Methods</b>: We conducted a narrative literature review of studies published between 2000 and 2024 that investigated corticosteroid therapy in children with <i>Mycoplasma pneumoniae</i> pneumonia, including various clinical presentations such as severe <i>Mycoplasma pneumoniae</i> pneumonia and refractory <i>Mycoplasma pneumoniae</i> pneumonia. Both randomized controlled trials and observational studies were included. <b>Results</b>: Early administration of corticosteroids, particularly within 24-36 h of hospital admission, was associated with improved clinical outcomes, including faster fever resolution, shorter hospital stay, and enhanced radiological recovery. High-dose regimens (≥5 mg/kg/day) or pulse therapy appeared effective in severe or refractory cases, while inhaled corticosteroids showed benefit in milder forms. Predictive factors for corticosteroid response included elevated C-reactive protein, lactate dehydrogenase, and ferritin levels. The overall safety profile was acceptable, with minimal adverse effects reported in most studies. <b>Conclusions</b>: Corticosteroids may play a beneficial role as adjunctive therapy in pediatric <i>Mycoplasma pneumoniae</i> pneumonia, especially in selected cases. However, further high-quality studies are required to define optimal timing, dosage, and patient selection.