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Efficacy of Corticosteroids in Tx of Pneumonia

Cochrane; ePub 2017 Dec 13; Stern, et al

Corticosteroid therapy reduced mortality in adults with severe community-acquired pneumonia (CAP), but not in adults and children with non-severe CAP, according to a recent Cochrane review. 17 randomized clinical trials (RTCs) with 2,264 participants were included in the review; 13 RCTs included 1,954 adult participants and 4 RTCs included 310 children. The RTCs assessed systemic corticosteroid therapy, given as adjunct to antibiotic treatment, vs placebo or no corticosteroids for adults and children with pneumonia. Among the findings:

  • Corticosteroids significantly reduced mortality in adults with severe pneumonia (RR, 0.58), but not in adults with non-severe pneumonia (RR, 0.95).
  • Corticosteroid therapy reduced morbidity, but not mortality, for adults and children with non-severe CAP.
  • Patients treated with corticosteroids had lower clinical failure rates, shorter time to cure, shorter hospital length of stay, and fewer complications.
  • Corticosteroid therapy was associated with more adverse events, especially hyperglycemia, but the harms did not outweigh the benefits.

Citation:

Stern A, Skalsky K, Avni T, Carrara E, Leibovici L, Paul M. Corticosteroids for pneumonia. Cochrane Database of Systematic Reviews 2017, Issue 12. Art. No.: CD007720. doi:10.1002/14651858.CD007720.pub3.