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Systemic Corticosteroid Therapy Can Improve Outcomes in CAP

Mortality, need for mechanical ventilation, hospital stay down in community-acquired pneumonia

TUESDAY, Aug. 11, 2015 (HealthDay News) — For hospitalized adults with community-acquired pneumonia (CAP), systemic corticosteroid therapy is associated with improved outcomes, according to a review published online Aug. 11 in the Annals of Internal Medicine.

Reed A.C. Siemieniuk, M.D., from McMaster University in Hamilton, Canada, and colleagues conducted a review to examine the effect of adjunctive corticosteroid therapy on mortality, morbidity, and duration of hospitalization in patients with CAP. Patients had a median age in the 60s and about 60 percent were male.

The researchers observed a correlation between adjunctive corticosteroids and possible reductions in all-cause mortality (risk difference, 2.8 percent); need for mechanical ventilation (risk difference, 5.0 percent); and acute respiratory distress syndrome (risk difference, 6.2 percent). There was also a decrease seen in time to clinical stability (mean difference, −1.22 days) and duration of hospitalization (mean difference, −1.00 days) with corticosteroids. The frequency of hyperglycemia requiring treatment was increased with adjunctive corticosteroids (risk difference, 3.5 percent), but there was no increase in the frequency of gastrointestinal hemorrhage.

“For hospitalized adults with CAP, systemic corticosteroid therapy may reduce mortality by approximately 3 percent, need for mechanical ventilation by approximately 5 percent, and hospital stay by approximately one day,” the authors write.

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