Systemic Corticosteroids in Children With Pneumonia: Α Systematic Review and Meta-analysis.

Area of Science:

• Pediatric Infectious Diseases
• Clinical Pharmacology
• Respiratory Medicine

Background:

• Corticosteroids are established treatments for specific infectious diseases.
• The efficacy and safety of corticosteroids in pediatric community-acquired pneumonia (CAP) are not well-defined.
• This study evaluates adjunct corticosteroid therapy in pediatric CAP.

Purpose of the Study:

• To assess the efficacy of systemic corticosteroids as an adjunct treatment for pediatric CAP.
• To evaluate the safety profile of corticosteroid use in children with CAP.
• To determine the impact of corticosteroids on clinical outcomes like hospital stay and fever duration.

Main Methods:

• A systematic literature search was performed on MEDLINE up to December 31, 2024.
• Included studies assessed systemic corticosteroids alongside antimicrobial regimens in pediatric CAP.
• Meta-analysis was conducted on data from randomized clinical trials and observational studies, assessing heterogeneity and publication bias.

Main Results:

• The systematic review included 22 articles (N=75,353).
• Meta-analysis of 7 studies showed significantly reduced length of hospital stay (LOS) and time to defervescence in pediatric CAP patients receiving corticosteroids in randomized trials (P=0.001 and P<0.001, respectively).
• Corticosteroids were associated with faster radiologic and clinical recovery, particularly in Mycoplasma pneumoniae and viral pneumonia with wheezing; adverse events were infrequent and manageable.

Conclusions:

• Adjunct corticosteroid therapy shows potential benefits for selected pediatric CAP patients.
• Further research is required to establish optimal protocols for corticosteroid administration in pediatric CAP.
• The findings suggest a possible advantage in specific pediatric CAP cases, warranting further investigation into timing and dosage.