The following is a summary of “Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials,” published in the April 2024 issue of Critical Care by Cheema et al.
The effectiveness of corticosteroids in treating community-acquired pneumonia (CAP) is still being debated.
Researchers conducted a retrospective study examining the effectiveness of adding corticosteroids to the treatment regimen for CAP and identifying factors that might influence the outcome.
They searched MEDLINE, Embase, the Cochrane Library, and trial registers to identify RCTs on corticosteroids in adult patients with CAP (March 2023). The primary outcome assessed the risk of all-cause mortality within 30 days post-randomization. Risk ratios (RR) and mean differences (MDs) were pooled using a random-effects model.
The results showed 15 RCTs with a total of 3,252 patients. Corticosteroids reduced the risk of all-cause mortality in patients with CAP by 31% (RR): 0.69, 95% CI): 0.53–0.89), with high certainty. Significant reduction was limited to hydrocortisone therapy and patients with severe CAP. Corticosteroids reduce the incidence of shock and the need for mechanical ventilation (MV), decreasing the length of hospital and ICU stay with moderate certainty.
Investigators found that corticosteroids helped patients with pneumonia, particularly on hydrocortisone, by reducing death risk, mechanical ventilation needs, shock, and hospital/ICU stays.
Source: sciencedirect.com/science/article/pii/S0883944123002563