Adjuvant therapy with steroids or immunoglobulins

Chemotherapy with antimicrobials is the basic treatment for pneumonia. Compared with community-acquired pneumonia, more cases of hospital-acquired pneumonia develop serious complications with ALI/ARDS, disseminated intravascular coagulation (DIC) or other conditions, and in many cases a number of drugs are used as adjuvant therapies. Adjuvant therapies include steroids, immunoglobulins, granulocyte-colony stimulating (G-CSF), blood purification and neutrophil elastase inhibitors. Little evidence has been accumulated in favour of these adjuvant therapies in pneumonia and their use is left to the discretion of the physician, but the indications should be considered carefully and general use avoided.