The following is a summary of ‘’Efficacy and safety of adjunctive corticosteroids in the treatment of severe community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials,” published in the July 2023 issue of Critical Care by Wu et al.
Researchers performed a retrospective study to examine the effectiveness and safety of systemic corticosteroids in treating severe community-acquired pneumonia (sCAP). A systematic search of 4 databases (Medline, Embase, ClinicalTrials.gov, and Scopus) was conducted to find RCTs of corticosteroids for sCAP up to April 24, 2023.
The primary outcome was 30-day all-cause mortality. A meta-analysis of 1689 RCTs found that adjunctive corticosteroids were associated with a lower mortality rate ( (risk ratio [RR], 0.61; 95% CI 0.44 to 0.85; P< 0.01) with low heterogeneity (I2 = 0%, P= 0.42) 3, reduced need for mechanical ventilation (RR 0.57; 95% CI 0.45 to 0.73; P< 0.001), shorter length of ICU stay (MD − 0.8; 95% CI − 1.4 to − 0.1; P= 0.02), and shorter hospital (MD − 1.1; 95% CI − 2.0 to − 0.1; P= 0.04) in patients with sCAP. There was no significant difference in the risk of gastrointestinal tract bleeding (RR 1.03; 95% CI 0.49 to 2.18; P= 0.93), healthcare-associated infection (RR 0.89; 95% CI 0.60 to 1.32; P= 0.56), or acute kidney injury (RR 0.68; 95% CI 0.21 to 2.26; P= 0.53) between the two groups.
Study concluded that adjunctive corticosteroids may improve survival and clinical outcomes in patients with sCAP, but more research is needed to confirm these findings.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-023-04561-z