Lancet Reg Health Europe
Short steroid course speeds oxygen recovery in Mycoplasma pneumonia
Clinical Takeaway: In hypoxemic adults hospitalized with confirmed M pneumoniae pneumonia, a 5-day course of oral betamethasone may hasten resolution of hypoxemia without increasing serious adverse events.
Mycoplasma pneumoniae accounts for a sizable share of adult community-acquired pneumonia (CAP) admissions, yet evidence guiding adjunctive anti-inflammatory therapy has been limited.
Adjunctive corticosteroids have shown benefit in severe community-acquired pneumonia, but data specific to M pneumoniae are sparse. To address this gap, investigators in Sweden conducted an open-label, multicentre randomized controlled trial across eight hospitals, testing whether short-course betamethasone could accelerate recovery from hypoxemia in adults hospitalized with M pneumoniae pneumonia.
Between 2018 and 2024, 70 adults with confirmed M pneumoniae CAP and hypoxemia (SpO2 <93% with tachypnoea) were randomized to standard care alone or standard care plus oral betamethasone (3 mg daily on days 1–2, then 2 mg daily on days 3–5). All patients received doxycycline for 10 days. Median age was 42 years, and 57% were men.
Time to resolution of hypoxemia (the primary outcome) was significantly shorter with betamethasone. Median time was 2.3 days in the steroid group vs. 3.6 days with standard care alone, corresponding to a hazard ratio of 1.82 (95% confidence interval, 1.10–3.02; p=0.020). Nearly all participants recovered, and adverse event rates were similar between groups, with no severe events attributed to betamethasone.
“Adjunctive betamethasone was well tolerated and significantly shortened the duration of hypoxaemia,” the authors concluded, suggesting a targeted role for corticosteroids in selected patients with M pneumoniae pneumonia.
Source: Hagman K, et al. (2026, April 19). Lancet Reg Health Europe. Adjunctive betamethasone treatment of hypoxaemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial