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Corticosteroids reduce death, hospital length of stay among CAP patients
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A regimen of systemic corticosteroids appears to yield measurable decreases in mortality, need for mechanical ventilation and duration of hospital stay among adults hospitalized with community-acquired pneumonia, according to recent data.
In the systematic review and meta-analysis, researchers queried MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from Jan. 1, 2010 to May 24, 2015 to examine the effect of adjunctive corticosteroid therapy. Eligible studies were found using the search terms “pneumonia” and “corticosteroid,” and involved the random allocation of adults with community-acquired pneumonia (CAP) to oral or IV corticosteroid therapy and placebo or no treatment.
There were 13 randomized, controlled trials identified that fit these criteria. Among these, the majority (60%) of participants were men, with median age in the early 60s.
The researchers found that within 12 of these trials (n = 1,974), adjunctive corticosteroids were related to potential reductions in all-cause mortality (RR = 0.67; 95% CI, 0.45-1.01). In five trials (n=1,060) corticosteroids were also linked to decreased need for mechanical ventilation (RR = 0.45; 95% CI, 0.26-0.79), and in four trials (n=945), corticosteroids were associated with a decrease in acute respiratory distress syndrome (RR = 0.24; 95% CI, 0.10-0.56).
According to the researchers, further investigation is needed into the potential benefits of systemic corticosteroids in patients with CAP.
“Larger pragmatic trials could improve certainty associated with several important outcomes, including mortality, need for mechanical ventilation, [acute respiratory distress syndrome], gastrointestinal bleeding, and neuropsychiatric disturbance,” the researchers wrote. “Decision makers should seriously consider the use of corticosteroids in patients hospitalized with CAP, particularly in those who are more severely affected.” –by Jen Byrne
Disclosure: The researchers report no relevant disclosures.
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