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Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
Adjunctive therapy in community-acquired pneumonia.
Richard G Wunderink1, Lionel Mandell
1Department of Medicine, Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Chicago, IL 60611, USA. r-wunderink@northwestern.edu
Seminars in Respiratory and Critical Care Medicine
|June 22, 2012
Summary
Adjunctive therapies for community-acquired pneumonia (CAP) are being explored. While macrolides show promise, evidence for corticosteroids and NSAIDs is limited, necessitating further research into host-response treatments for severe CAP.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pharmacology
Background:
- Community-acquired pneumonia (CAP) is a leading cause of death in the US, despite antibiotic use.
- There is a need for adjunctive therapies targeting the host response in severe CAP.
- Understanding host response pathways is crucial for improving CAP outcomes.
Purpose of the Study:
- To review current adjunctive therapies for severe community-acquired pneumonia.
- To evaluate the potential role of immunomodulatory agents and other host-directed treatments.
- To identify areas for future research in CAP management.
Main Methods:
- Literature review of existing studies on adjunctive therapies for CAP.
- Analysis of evidence for macrolide antibiotics, corticosteroids, NSAIDs, statins, and anticoagulation agents.
- Assessment of theoretical benefits and clinical trial status of novel therapies.
Main Results:
- Macrolide antibiotics may offer immunomodulatory benefits in severe CAP.
- Corticosteroids lack clear demonstrated benefit, requiring larger trials.
- NSAIDs may improve oxygenation but not mortality; statin use before diagnosis shows benefit.
- Anticoagulation therapies (drotrecogin alfa, tifacogin) have not shown survival benefits.
Conclusions:
- Adjunctive therapies targeting host response are attractive for severe CAP management.
- Further research is needed for corticosteroids, statins initiated at diagnosis, and other novel agents.
- Current evidence suggests limited benefit from NSAIDs and anticoagulation therapies for mortality reduction in CAP.
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