A recently published meta-analysis summarized the data for using corticosteroids to treat community-acquired pneumonia, as reported by Medscape.
A recent meta-analysis published in the Annals of Internal Medicine[1] summarized the data for using corticosteroids to treat community-acquired pneumonia (CAP). This was after two large, randomized, controlled trials published earlier in 2015 showed that using corticosteroids for CAP decreases time required to achieve clinical stability and reduces hospital stay.[2,3] Mortality was a secondary outcome for both studies, and neither showed a mortality difference.
A Cochrane review published in 2011 produced similar findings. There was evidence for accelerated clinical resolution with steroids with weak evidence against a mortality benefit.[4]
The Annals meta-analysis looked at a range of outcomes and included considerably more patients than the 2011 Cochrane review. If I were to briefly summarize the Annals results, I’d say that the findings confirm what we already know. Corticosteroids improve time to stability and reduce hospital stay at the cost of clinically insignificant hyperglycemia. From an evidence-based perspective, these results sound underwhelming, particularly because the oldest study in the meta-analysis was from 1972. It seems that we’ve been trying to figure out the effect corticosteroids have on CAP for a long time.
