Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis

Area of Science:

• Pulmonology
• Critical Care Medicine
• Infectious Diseases

Background:

• Corticosteroids are used as adjunctive therapy in tuberculosis, particularly for meningeal and pericardial forms.
• Their use in severe pulmonary tuberculosis requiring mechanical ventilation is controversial.

Purpose of the Study:

• To investigate the association between corticosteroid use and in-hospital mortality in pulmonary tuberculosis patients on mechanical ventilation.

Main Methods:

• Retrospective cohort study including adult tuberculosis patients requiring mechanical ventilation.
• Data collected on corticosteroid administration and in-hospital mortality.

Main Results:

• A total of 467 patients were analyzed; 399 received corticosteroids and 68 did not.
• Mortality rate was significantly higher in the corticosteroid group (59.9%) compared to the non-corticosteroid group (41.2%) (p=0.010).
• No significant difference in total corticosteroid dose (prednisone equivalents) was observed between survivors and non-survivors.

Conclusions:

• Corticosteroid administration in mechanically ventilated tuberculosis patients was associated with increased in-hospital mortality.
• The precise role of corticosteroids in managing critically ill pulmonary tuberculosis patients remains uncertain and warrants further investigation in prospective trials.