Corticosteroids for pneumonia

Abstract

Analysis 3.2. Comparison 3 Budesonide (Pulmicort) plus antibiotics versus antibiotics only, Outcome 2 Rate of relapse. Analysis 4.1. Comparison 4 Intravenous dexamethasone versus placebo, Outcome 1 Duration of mechanical ventilation. Analysis 4.2. Comparison 4 Intravenous dexamethasone versus placebo, Outcome 2 Duration of supplemental oxygen. Analysis 4.3. Comparison 4 Intravenous dexamethasone versus placebo, Outcome

Guidelines for diagnosis and management of community-and hospital-acquired pneumonia in adults: Joint ICS/NCCP(I) recommendations

“…[216] There is some benefit of steroids in CAP, but there is no significant reduction in mortality, and the increased risk of arrhythmias, upper gastrointestinal bleeding, and malignant hypertension may be possibly related to corticosteroids. [221] The use of glucocorticoids should be limited to patients with vasopressor-dependent septic shock and patients with early acute respiratory distress syndrome. [222–226]…”

Impact and indication of early systemic corticosteroids for very severe community-acquired pneumonia

“…However, not many CAP studies have shown that adjunctive systemic corticosteroids reduce the risk of mortality 6–9,17. A recent meta-analysis showed that the addition of systemic corticosteroids for treatment of pneumonia accelerated the resolution of symptoms but did not reduce the mortality 18. To our knowledge, only two CAP studies have shown the efficacy of systemic corticosteroids for reducing mortality 5,19.…”

Adjunctive corticosteroids improve the need for mechanical ventilation and shorten hospital duration in patients hospitalised with community-acquired pneumonia

“…This systematic review and meta-analysis built on a previous Cochrane Review,2 updating the literature search (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) from January 2010 until May 2015. Eligible studies randomly assigned adults hospitalised with CAP to oral or intravenous corticosteroid therapy versus placebo or no treatment and reported on at least one of the following outcomes: duration of hospitalisation, time to clinical stability, all-cause mortality, need for mechanical ventilation, need for intensive care unit admission or development of the acute respiratory distress syndrome (ARDS).…”