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For adult patients with severe community-acquired pneumonia, corticosteroids
reduce morbidity and mortality. For pediatric patients and adults with nonsevere
community-acquired pneumonia, corticosteroids appear to reduce morbidity, but
not mortality.
difference in mortality in this limiting the conclusions that can 3. Niederman MS, McCombs JS, Unger AN,
et al. The cost of treating community-
subgroup. be drawn from those data. acquired pneumonia. Clin Ther.
1998;20:820-837.
The current systemic review has In summary, the current data sug- 4. Rhen T, Cidlowski JA. Antiinflammatory
several limitations that must be gest that corticosteroids reduce action of glucocorticoids—new mechanism
considered in light of the above for old drugs. N Engl J Med.
morbidity and mortality in severe 2005;353:1711-1723.
findings. First, the studies included community-acquired pneumonia. 5. Kellum JA, Kong L, Fink MP, et al.
in the meta-analysis varied in the Corticosteroids were also shown Understanding the inflammatory
doses, days of total treatment, and cytokine response in pneumonia and
to be beneficial in patients with sepsis: results of the Genetic and
type of corticosteroid adminis- nonsevere community-acquired Inflammatory Markers of Sepsis (GenIMS)
tered. Future studies should pneumonia who were admitted Study. Arch Intern Med.
compare the effect between to the hospital. The administration 2007;167:1655-1663.
6. Ellison RT 3rd, Donowitz GR. Acute
different types, doses, and treat- of corticosteroids was associated pneumonia. In: Mandell GL, Bennett JE, eds.
ment durations of corticosteroids. with an increased rate of hyper- Mandell, Douglas and Bennett’s Principles
Although statistical heterogeneity glycemia, without a difference in and Practice of Infectious Diseases. 8th ed.
was relatively low, there was a London, England: Churchill Livingstone;
other adverse events. 2015.
moderate amount of clinical het- 7. Brouwer MC, McIntyre P, Prasad K, et al.
erogeneity between the pop- Editor’s Note: This is a clinical Corticosteroids for acute bacterial meningitis.
ulations. Additionally, this review synopsis, a regular feature of the Cochrane Database Syst Rev.
Annals’ Systematic Review Snapshot 2015;(9):CD004405.
included patients with a variety of (SRS) series. The source for this 8. Gottlieb M, Bailitz J. Do corticosteroids
medical conditions (eg, chronic systematic review snapshot is: Stern provide benefit to patients with community-
obstructive pulmonary disease, A, Skalsky K, Avni T, et al. acquired pneumonia? Ann Emerg Med.
Corticosteroids for pneumonia. 2016;67:640-642.
diabetes), who may respond 9. Blum CA, Nigro N, Briel M, et al.
differently than patients without Cochrane Database Syst Rev.
Adjunct prednisone therapy
2017;12:CD007720.
these comorbidities. Moreover, for patients with community-
many of the outcomes were acquired pneumonia: a multicentre,
1. World Health Organization. The top 10 double-blind, randomised, placebo-
limited by small sample sizes, with causes of death. Available at: http://www. controlled trial. Lancet.
one study comprising nearly half who.int/mediacentre/factsheets/fs310/en/. 2015;385:1511-1518.
of all of the included patients.9 Accessed March 28, 2018.
Michael Brown, MD, MSc, Jestin N.
2. Xu J, Murphy SL, Kochanek KD, et al. Deaths:
Finally, the sample sizes in the final data for 2013. Natl Vital Stat Rep. Carlson, MD, MS, and Alan Jones, MD,
pediatric studies were very small, 2016;64:1-119. serve as editors of the SRS series.