Efficacy of corticosteroid treatment for severe community‐acquired pneumonia: A meta‐analysis

@article{Wu2017EfficacyOC,
  title={Efficacy of corticosteroid treatment for severe community‐acquired pneumonia: A meta‐analysis},
  author={Wei-Fang Wu and Qiang Fang and Guo-jun He},
  journal={American Journal of Emergency Medicine},
  year={2017},
  volume={36},
  pages={179–184}
}

Figures and Tables from this paper

Efficacy and safety of adjunctive corticosteroids therapy for patients with severe community-acquired pneumonia

Overall, adjunctive systemic corticosteroids therapy was effective and safe for patients with severe CAP and the effects of mortality may differ according to the type of cortiosteroids.

Corticosteroids as Adjunctive Therapy in the Treatment of Influenza: An Updated Cochrane Systematic Review and Meta-analysis.

Coricosteroid treatment in influenza is associated with increased mortality and hospital-acquired infection, but the evidence relates mainly to high corticosteroid doses and is of low quality with potential confounding by indication a major concern.

The benefits or harms of systemic corticosteroids for community-acquired pneumonia in adults: аn overview of reviews

Assessment of evidence for the effect of adjuvant systemic CS in adults with CAP on mortality, symptom dynamics, risk of complications, and harmful side effects shows that there is a feasibility of bridging the gap between existing regulations and the evidence base for current systematic reviews of RCTs on the use of CS in CAP.

Real-world corticosteroid use in severe pneumonia: a propensity-score-matched study

Corticosteroid treatment may be of benefit for patients with CAP who have septic shock and/or a high inflammatory response and requirement for invasive mechanical ventilation, and Corticosteroids appear to have no impact on mortality when these features are not present.

The role of steroids in severe CAP

S steroids were deleterious in influenza pneumonia and in patients with pneumococcal pneumonia data suggest a lack of efficacy and potential harm, and both European and American guidelines recommend not using corticosteroids in CAP.

Corticosteroids as adjunctive therapy in the treatment of influenza.

It is found that adjunctive corticosteroid therapy was associated with increased mortality, and this result should be interpreted with caution.

Effects of different doses of methylprednisolone on clinical outcomes in patients with severe community-acquired pneumonia: a study protocol for a randomized controlled trial

The results of this study may find the optimal dose of glucocorticoid in the adjuvant treatment of SCAP and provide evidence-based proof for clinicians to treat patients with SCAP.

Challenges in severe community-acquired pneumonia: a point-of-view review

The main controversies in SCAP are discussed: the role of severity scores to guide patient settings of care and empiric antibiotic therapy; the emergence of pathogens outside the core microorganisms of CAP; viral SCAP; the best empirical treatment; septic shock as the most lethal complication; and the need for new antibiotics.

2018 recommendations for the management of community acquired pneumonia

  • R. A. CorrêaA. Costa M. Pereira
  • Medicine
    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
  • 2018
Thirteen members with recognized experience in CAP in Brazil who identified issues relevant to clinical practice that require updates given the publication of new epidemiological and scientific evidence are summoned.

References

SHOWING 1-10 OF 21 REFERENCES

Efficacy and Safety of Corticosteroids for Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis.

Short-term treatment with corticosteroids is safe and may reduce the risk of ARDS, shortening the length of the disease in patients with CAP and patients with severe CAP were not associated with increased rates of adverse events.

Corticosteroid Therapy for Severe Community-Acquired Pneumonia: A Meta-Analysis

It is suggested that, although corticosteroid therapy may reduce mortality and improve the prognosis of adult patients with severe CAP, the results should be interpreted with caution due to the instability of pooled estimates.

Adjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-Analysis

Adjunctive corticotherapy is associated with a reduction of length of stay, time to clinical stability, and severe complications among patients with CAP, but the effect on mortality remains uncertain.

Efficacy of corticosteroids in community-acquired pneumonia: a randomized double-blinded clinical trial.

Because of its association with increased late failure and lack of efficacy prednisolone should not be recommended as routine adjunctive treatment in CAP, and a benefit in more severely ill patients cannot be excluded.

Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial

MPDN treatment, in combination with antibiotics, improves respiratory failure and accelerates the timing of clinical resolution of severe CAP needing hospital admission.

Efficacy of Corticosteroids in the Treatment of Community-Acquired Pneumonia Requiring Hospitalization

In moderate–severe CAP, administration of corticosteroids promotes resolution of clinical symptoms and reduces the duration of intravenous antibiotic therapy.

Clinical efficacy of glucocorticoids in the treatment of severe community acquired pneumonia and its impact on CRP

Glucocorticoids can significantly improve the clinical efficacy in the treatment of patients with SCAP, affect the release of CRP, and regulate inflammatory response and is a safe and reliable method and worthy of widely clinical application.

Severe community-acquired pneumonia as a cause of severe sepsis: Data from the PROWESS study*

In patients with severe sepsis resulting from CAP, a readily identifiable disease, DrotAA, improved survival compared with placebo and the survival benefit was most pronounced in severe CAP patients with S. pneumoniae.

Low-dose corticosteroid use and mortality in severe community-acquired pneumonia patients

Low-dose corticosteroid use in severe CAP patients was associated with better prognosis only in those with septic shock complicating CAP, and may be associated with reduced 28-day mortality.

Hydrocortisone and tumor necrosis factor in severe community-acquired pneumonia. A randomized controlled study.

Hydrocortisone given prior to antibiotic treatment had no effect on the serum TNF-alpha levels or the clinical course of patients with severe community-acquired pneumonia.