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. 2008;12(3):R76.
doi: 10.1186/cc6922. Epub 2008 Jun 11.

The role of corticosteroids in severe community-acquired pneumonia: a systematic review

Jorge I F Salluh  1 , Pedro Póvoa, Márcio Soares, Hugo C Castro-Faria-Neto, Fernando A Bozza, Patrícia T Bozza
Affiliations

The role of corticosteroids in severe community-acquired pneumonia: a systematic review

Jorge I F Salluh et al. Crit Care. 2008.

Erratum in

  • Crit Care. 2008 Nov 7;12(6):434

Abstract

Introduction: The purpose of this review was to evaluate the impact of corticosteroids on the outcomes of patients with severe community-acquired pneumonia (CAP).

Methods: We performed a systematic MEDLINE, Cochrane database, and CINAHL search (1966 to November 2007) to identify full-text publications that evaluated the use of corticosteroids in CAP.

Results: An initial literature search yielded 109 articles, and 105 studies were excluded after the first analysis. We found four studies eligible for analysis. On the basis of their results, the use of corticosteroids as adjunctive therapy in severe CAP should be categorized as a weak recommendation (two studies) and a strong recommendation (two studies) with either low- or moderate-quality evidence. However, no evidence of adverse outcomes or harm is present in the evaluated studies.

Conclusion: According to the GRADE system, available studies do not support the recommendation of corticosteroids as a standard of care for patients with severe CAP. Further randomized controlled trials with this aim should enroll a larger number of severely ill patients. However, in patients needing corticosteroids, it may be reasonable to conclude that corticosteroid administration is safe in patients with severe infections receiving antimicrobial therapy.

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Figures

Figure 1
Figure 1
Flow diagram of selection of studies. CAP, community-acquired pneumonia.
See this image and copyright information in PMC

Comment in

References

    1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Jr, Musher DM, Niederman MS, Torres A, Whitney CG. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27–72. doi: 10.1086/511159. - DOI - PMC - PubMed
    1. Niederman MS. Recent advances in community-acquired pneumonia: inpatient and outpatient. Chest. 2007;131:1205–1215. doi: 10.1378/chest.06-1994. - DOI - PMC - PubMed
    1. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–1377. doi: 10.1056/NEJMoa010307. - DOI - PubMed
    1. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ., Jr Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699–709. doi: 10.1056/NEJM200103083441001. - DOI - PubMed
    1. Marshall JC. Such stuff as dreams are made on: mediator-directed therapy in sepsis. Nat Rev Drug Discov. 2003;2:391–405. doi: 10.1038/nrd1084. - DOI - PubMed

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