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Adjunct prednisone therapy for patients with community-acquired pneumonia

Authors :
Simone Birocchi
Giulia Cernuschi
Source :
Internal and emergency medicine. 10(5)
Publication Year :
2015

Abstract

Pneumonia is one of the principal causes of morbidity and mortality worldwide, despite the advances in antibiotic therapies and in preventive measures [1]. The intense inflammatory response that was of fundamental importance in the pre-antibiotics era nowadays might be excessive. In fact, it can lead to multiple organ failure, thus causing more harm than benefit [2]. Corticosteroids have a strong antiinflammatory effect; therefore, their use in pneumonia has been studied for a long time. One of the most important trials was recently published by Meijvis [3]. A 4-day course of 5 mg of dexamethasone was compared to placebo, showing a 1-day reduction in hospital stay, but no difference in mortality. A meta-analysis by Nie [4] does not find any significant reduction in pneumonia overall mortality; however, a subgroup analysis shows a significant reduction in mortality in both studies considering patients with severe pneumonias and treating subjects for more than 5 days. Therefore, the authors conclude that adequately powered double-blind randomized controlled trials (RCTs) are warranted to give recommendations for the use of steroids in pneumonia. Summary

Details

ISSN :
19709366
Volume :
10
Issue :
5
Database :
OpenAIRE
Journal :
Internal and emergency medicine
Accession number :
edsair.doi.dedup.....28cdf0dbd61305a53441659b261b26e2