Corticosteroids for pneumonia

Yuanjing, Chen; Li, Ka; Pu, Hongshan; Wu, Taixiang

doi:10.1002/14651858.cd007720

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…A 2011 Cochrane review that included relevant CAP studies through the year 2010 showed that corticosteroid use accelerates time to symptom resolution and clinical stability, with infrequent adverse effects [17]. Similarly, a 2015 systematic review by Siemie-Niuk and colleagues included…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Using Prednisolone in Children with Community – Acquired Pneumonia

Sadikov

Yue

Hong

et al. 2021

AJPR

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Community-acquired Pneumonia (CAP) is an infection of the lung parenchyma that is acquired outside of hospital, [1] involved approximately 150 million new cases annually, among children younger than 5 years old worldwide. We retrospectively evaluated the effect of Prednisolone in 89 children with CAP who were admitted to the 2nd hospital of Shandong University (China) and Infectious diseases of Andijon region (Uzbekistan). The mean age was 6.3 in China (Placebo) and 9.3 in Uzbekistan (control) years, 54% and 52% of them were boys respectively. All children had received broad spectrum antibiotics (cephalosporin) or Macrolides (Azithromycin) and Oxygen. In addition to these we added Prednisolone 1 mg/kg on day 2 of admission to control group. 24 (68.5% from all febrile) children were became afebrile within 24 hours after Predisolone use on day 3 of admission, and their clinical status developed in control group, when it was achieved on day 7 in Placebo group. Hospital days also shortened in control group (6 days) than placebo (8 days) (p value ≤ 0.01). In conclusion, steroid therapy helpful for reducing hospital stay and morbidity in children with community-acquired Pneumonia and no observed side effects.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Using Prednisolone in Children with Community – Acquired Pneumonia

Sadikov

Yue

Hong

et al. 2021

AJPR

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“…A 2017 Cochrane meta-analysis showed an increase in cases of hyperglycemia (RR 1.72; 95% CI 1.38–2.14) linked to the use of GCs [ 105 ]; beyond this, the numerous comparisons between people treated with GCs and controls, also performed during the COVID-19 pandemic, did not show significant differences in the incidence of secondary infections or adverse events (RR 1.19; 95% CI 0.73–1.93). In the studies, hyperglycemia occurred without other significant consequences and was self-resolved after suspension of GC treatment [ 19 , 26 , 106 , 107 , 108 ].…”

Section: Complications and Adverse Eventsmentioning

confidence: 99%

Theory and Practice of Glucocorticoids in COVID-19: Getting to the Heart of the Matter—A Critical Review and Viewpoints

et al. 2023

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Prolonged, low-dose glucocorticoids (GCs) have shown the highest efficacy among pharmacological and non-pharmacological treatments for COVID-19. Despite the World Health Organization’s recommendation against their use at the beginning of the pandemic, GCs at a dose equivalent to dexamethasone 6 mg/day for 10 days are now indicated in all COVID-19 cases who require respiratory support. However, the efficacy of the intervention depends on the timing of initiation, the dose, and other individual factors. Indeed, patients treated with similar GC protocols often experience different outcomes, which do not always correlate with the presence of comorbidities or with the severity of respiratory involvement at baseline. This prompted us to critically review the literature on the rationale, pharmacological principles, and clinical evidence that should guide GC treatment. Based on these data, the best treatment protocol probably involves an initial bolus dose to saturate the glucocorticoid receptors, followed by a continuous infusion to maintain constant plasma levels, and eventually a slow tapering to interruption. Methylprednisolone has shown the highest efficacy among different GC molecules, most likely thanks to its higher ability to penetrate the lung. Decreased tissue sensitivity to glucocorticoids is thought to be the main mechanism accounting for the lower response to the treatment in some individuals. We do not have a readily available test to identify GC resistance; therefore, to address inter-individual variability, future research should aim at investigating clinical, physiological, and laboratory markers to guide a personalized GC treatment approach.

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“…Dexamethasone is a corticosteroid exhibiting potent anti-inflammatory and immunosuppressant effects. Since the 1960s, it has been used to treat many conditions, including severe pneumonia, rheumatic problems, skin diseases, severe allergies, asthma, chronic obstructive lung disease, brain swelling, and many others ( 3 , 4 ). Dexamethasone suppresses the immune system by stimulating the glucocorticoid receptor, thus providing some relief for patients whose lungs are devastated by an overactive immune response that accompanies severe cases of COVID-19, but no benefit for those patients who did not require respiratory support ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Molecular determinants of vascular transport of dexamethasone in COVID-19 therapy

Shabalin

Czub

Majorek

et al. 2020

Preprint

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Dexamethasone, a widely used corticosteroid, has recently been reported as the first drug to increase the survival chances of patients with severe COVID-19. Therapeutic agents, including dexamethasone, are mostly transported through the body by binding to serum albumin. Herein, we report the first structure of serum albumin in complex with dexamethasone. We show that it binds to Drug Site 7, which is also the binding site for commonly used nonsteroidal anti-inflammatory drugs and testosterone, suggesting potentially problematic binding competition. This study bridges structural findings with our analysis of publicly available clinical data from Wuhan and suggests that an adjustment of dexamethasone regimen should be considered for patients affected by two major COVID-19 risk-factors: low albumin levels and diabetes.One Sentence SummaryStructure of serum albumin with dexamethasone reveals why the drug may not always help COVID-19 patients.

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Corticosteroids for pneumonia

Cited by 3 publications

References 8 publications

The Effectiveness of Using Prednisolone in Children with Community – Acquired Pneumonia

The Effectiveness of Using Prednisolone in Children with Community – Acquired Pneumonia

Theory and Practice of Glucocorticoids in COVID-19: Getting to the Heart of the Matter—A Critical Review and Viewpoints

Molecular determinants of vascular transport of dexamethasone in COVID-19 therapy

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