Objective To observe the clinical efficacy of azithromycin combined with acetylcysteine alveolar lavage in the treatment of severe Mycoplasma pneumoniae pneumonia (SMPP) in children.

Methods A total of 80 children with SMPP were selected as study subjects and divided into control group and observation group using a random number table method, with 40 cases in each group. The control group was treated with intravenous drip of azithromycin injection and other general symptomatic treatments for 5 days. The observation group was treated with acetylcysteine alveolar lavage on the basis of the control group for 5 days. The clinical efficacy, laboratory indicators, and lung function indicators of the two groups were compared.

Results After 5 days of treatment, the total effective rate of treatment in the observation group was higher than that in the control group (P < 0.05). The duration of fever and lung moist rales in the observation group was shorter than that in the control group (P < 0.05). After 5 days of treatment, the tidal volume per kilogram of body mass (VT/kg), peak expiratory flow to peak expiratory time ratio (PTEF/TPTEF), forced expiratory flow at 25% residual tidal volume (FEF25%), and expiratory flow to peak expiratory flow ratio at 25% residual tidal volume (25/PF) of the two groups were higher than those before treatment, and VT/kg, PTEF/TPTEF, FEF25%, and 25/PF in the observation group were higher than those in the control group (P < 0.05).

Conclusion Azithromycin combined with acetylcysteine alveolar lavage can effectively improve the clinical efficacy of children with SMPP, shorten the duration of fever and lung moist rales, and improve lung function.