Treatment with anti‐inflammatory drugs in community‐acquired pneumonia

Meijvis, Sabine C. A.; Garde, E.M.W. van de; Rijkers, Ger T.; Bos, Willem Jan W.

doi:10.1111/j.1365-2796.2012.02554.x

Cited by 40 publications

(41 citation statements)

References 78 publications

(76 reference statements)

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“…However, while it is well recognised that inappropriate initial antibiotic therapy is associated with a worse outcome, it is also noted that even in the setting of appropriate initial antibiotic treatment, many patients still die (10). This has resulted in considerable interest in the potential role of adjunctive, anti-inflammatory therapies in the management of patients with CAP, particularly among the more seriously ill patients (1,(7)(8)(9)11,12). Shindo and colleagues recently studied risk factors for 30-day mortality in patients with CAP who had received appropriate antibiotic therapy, with the aim of trying to identify patients who were most likely to benefit from adjunctive therapy (10).…”

Section: Review Articlementioning

confidence: 99%

“…Awareness of the threat posed by CAP-associated, inflammation-mediated tissue damage and organ dysfunction, seemingly exacerbated by co-existent comorbidities, has motivated exploration of the therapeutic potential of adjunctive anti-inflammatory therapies (1,7,9,11,12). Foremost amongst these are corticosteroids (CS) and macrolides (1), with more recent interest in statins and platelet-targeted pharmacological agents (13).…”

Section: Review Articlementioning

confidence: 99%

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Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials

Feldman¹

2016

J. Thorac. Dis.

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Improving the outcome of patients with community-acquired pneumonia (CAP) is an ongoing challenge, even in the setting of significant advances in antimicrobial chemotherapy and critical care.Recognition of the underlying involvement of inflammation-mediated organ dysfunction as a determinant of adverse outcomes in CAP has aroused intense interest in the protective potential of adjunctive antiinflammatory therapies in CAP, particularly the role of corticosteroids (CS). This is the primary topic of the current review which is focused on an evaluation of the latest meta-analyses encompassing both recent and earlier clinical trials, with particular emphasis on the stringent meta-analysis undertaken by Siemieniuk and colleagues (Ann Intern Med 2015;163:519-528). The review highlights the findings and recommendations of these and related published commentaries/critiques, while providing a brief description of those subgroups of patients who seemingly stand to benefit most from CS therapy. This is preceded by an overview of the mechanisms of the anti-inflammatory activities of CS, the interactions of these agents with macrolide antibiotics, and the potential benefits and risks of short-term administration of CS, concluding with a succinct appraisal of priority issues for ongoing and future research.

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Section: Review Articlementioning

confidence: 99%

Section: Review Articlementioning

confidence: 99%

Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials

Feldman¹

2016

J. Thorac. Dis.

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“…4 Multiple trials have attempted to modulate this excessive immune response using corticosteroids and other drugs, but none have demonstrated significant benefit. 5 With a dearth of novel drug development for infection in recent years, increasingly efforts have focused on repurposing established drugs and investigating their possible immunomodulatory effects. HMG-CoA reductase inhibitors (statins) competitively inhibit HMG-CoA reductase, the first enzyme active in the mevalonate pathway, and are the most commonly prescribed drugs in the UK.…”

Section: Introductionmentioning

confidence: 99%

Statin therapy in patients with community-acquired pneumonia

et al. 2017

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Community-acquired pneumonia (CAP) is the leading cause of death from infection in developed countries. There is evidence of an association between improved survival from infection and statin use. The possible benefi cial effects of statins are complicated by the common use of macrolide antibiotics for pneumonia, with current guidance suggesting that concurrent macrolide and statin use is contraindicated. We conducted an observational study of statin use in patients with CAP. Of 2,067 patients with CAP, 30.4% were on statin therapy at admission. Statin users were more likely to survive the admission (p<0.001). In addition, we conducted a survey of doctors and found that knowledge regarding concurrent macrolide and statin use was lacking. These data suggest a potential role of statins in the management of CAP. Further research using high-dose statins is required to assess their safe use in subjects with mild to moderate infections.

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“…Dexamethasone is one of the synthetic corticosteroids that are clinically used to treat several inflammatory disorders and autoimmune diseases [219]. However, the benefits of adjunctive corticosteroid therapy of CAP have been under debate for a long time [227,239] due to conflicting results from different studies of this potential therapy [220,221,223,224,[240][241][242]. In our murine model of SBP, adjunctive dexamethasone treatment improved survival rates of pneumonic mice.…”

Section: Discussionmentioning

confidence: 81%

“…[227,239]. The answer to this question has been perplexed by the mixed results shown in several clinical studies of adjunctive corticosteroid use for treating pneumonia in humans [220,221,223,224,[240][241][242].…”

Section: Treatment Strategies Of Secondary Bacterial Pneumonia Followmentioning

confidence: 99%

A Novel Mechanism of Enhanced Susceptibility to Bacterial Pneumonia in Influenza-infected Hosts

Ghoneim¹

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Treatment with anti‐inflammatory drugs in community‐acquired pneumonia

Abstract: Abstract. Meijvis SCA, van de Garde EMW, Rijkers GT,

Cited by 40 publications

References 78 publications

Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials

Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials

Statin therapy in patients with community-acquired pneumonia

A Novel Mechanism of Enhanced Susceptibility to Bacterial Pneumonia in Influenza-infected Hosts

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