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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Corticosteroids for pneumonia.

Anat Stern1, Keren Skalsky, Tomer Avni

  • 1Division of Infectious Diseases, Rambam Health Care Campus, Ha-aliya 8 St, Haifa, Israel, 33705.

The Cochrane Database of Systematic Reviews
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Summary
This summary is machine-generated.

Corticosteroids significantly reduced mortality in adults with severe pneumonia and lowered clinical failure rates in both severe and non-severe cases. While associated with increased hyperglycemia, the benefits of corticosteroid treatment for pneumonia generally outweigh the harms.

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Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Pharmacology

Background:

  • Pneumonia is a prevalent and serious infection.
  • The role of corticosteroids in pneumonia treatment remains uncertain.
  • This review updates previous findings from 2011.

Purpose of the Study:

  • To evaluate the efficacy and safety of corticosteroid use in pneumonia treatment.
  • To synthesize evidence from randomized controlled trials on corticosteroid therapy for pneumonia.

Main Methods:

  • Systematic review and meta-analysis of 17 randomized controlled trials (RCTs) involving 2264 participants (adults and children).
  • Included RCTs compared systemic corticosteroids plus antibiotics versus placebo or no corticosteroids.
  • Data were analyzed using risk ratios (RR) with 95% confidence intervals (CI).

Main Results:

  • Corticosteroids significantly reduced mortality in adults with severe pneumonia (moderate-quality evidence).
  • Early clinical failure rates were significantly reduced in both severe and non-severe pneumonia (high-quality evidence).
  • Reduced time to clinical cure, shorter hospital/ICU stays, and fewer complications were observed; however, hyperglycemia increased in adults.

Conclusions:

  • Corticosteroid therapy improves outcomes for severe community-acquired pneumonia (CAP) in adults, with a number needed to treat of 18 to prevent one death.
  • Benefits in non-severe CAP (adults and children) were primarily related to reduced morbidity, not mortality.
  • Despite increased risk of hyperglycemia, corticosteroid treatment appears to offer more benefits than harms in pneumonia management.