August 19, 2015
Corticosteroids Reduce Hospital Stays, Complications
Hamilton, Ontario—Treating community-acquired pneumonia (CAP) patients with corticosteroids reduces hospital stays, the need for mechanical ventilation, and the complication rate, according to a new Canadian analysis of clinical studies.
The report, published recently in the Annals of Internal Medicine, was on research summarizing evidence from 13 randomized trials involving more than 2,000 patients. The study was led by researchers from McMaster University.
“Our study should lead to an important change in treatment for pneumonia,” lead author, Reed Siemieniuk, MD, said in a McMaster press release. “Corticosteroids are inexpensive and readily available around the world. Millions of patients will benefit from this new evidence.”
Background information in the article notes that lower respiratory infections are the second most common cause of premature mortality globally and that, in developed countries, hospitalization for CAP is common and is often associated with acute respiratory distress syndrome requiring mechanical ventilation and with significant mortality.
To determine the effectiveness of treatment with systemic corticosteroids in hospitalized adults with CAP, two reviewers independently extracted study data from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through May 2015, assessing risk of bias as well as quality of the evidence.
Results indicate positive results for the treatment with few downsides.
“For hospitalized adults with CAP, systemic corticosteroid therapy may reduce mortality by approximately 3%, need for mechanical ventilation by approximately 5%, and hospital stay by approximately one day,” the authors conclude.
Adjunctive corticosteroids resulted in more hyperglycemia requiring treatment, according to the review, but did not increase frequency of gastrointestinal hemorrhage
“Seldom do we see a major advance in treatment of a condition as common as community-acquired pneumonia,” said senior investigator Gordon Guyatt, MD, MSc, professor of clinical epidemiology and biostatistics at McMaster. “Corticosteroids over short periods are safe, and we now know that they achieve important benefits in a serious and common medical illness.”
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