Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 28:7:269.
doi: 10.12688/wellcomeopenres.18401.2. eCollection 2022.

A pragmatic randomized controlled trial of standard care versus corticosteroids plus standard care for treatment of pneumonia in adults admitted to Kenyan hospitals (SONIA)

Ruth Lucinde  1 , Abdirahman Abdi  1 , Benedict Orindi  1 , Stella Mwakio  1 , Henry Gathuri  1 , Edwin Onyango  1 , Salome Chira  1 , Morris Ogero  1 , Lynda Isaaka  1 , Jimmy Shangala  1 , Irene Njeri Oginga  2 , Alvin Wachira  3 , Evans Manuthu  4 , Hazel Kariuki  5 , Jared Nyikuli  6 , Cyprian Wekesa  6 , Amos Otedo  7 , Hannah Bosire  7 , Steve Biko Okoth  8 , Winston Ongalo  8 , David Mukabi  9 , Wilber Lusamba  9 , Beatrice Muthui  10 , Nicholas Kirui  11 , Isaac Adembesa  12 , Caroline Mithi  12 , Mohammed Sood  13 , Nadia Ahmed  14 , Bernard Gituma  15 , Vera Bina Ongaki  16 , Matiko Giabe  16 , Charles Omondi  17 , Loice Achieng Ombajo  18   19 , Wangeci Kagucia  1 , Mike English  1 , Mainga Hamaluba  1 , Lynette Isabella Ochola-Oyier  1 , Dorcas Kamuya  1 , Philip Bejon  1 , Ambrose Agweyu  1 , Samuel Akech  1 , Anthony Oliwa Etyang  1
Affiliations

A pragmatic randomized controlled trial of standard care versus corticosteroids plus standard care for treatment of pneumonia in adults admitted to Kenyan hospitals (SONIA)

Ruth Lucinde et al. Wellcome Open Res. .

Abstract

Background: Mortality among adults admitted to hospital with community acquired pneumonia in resource-limited settings is high. Recent studies conducted in high-income settings have demonstrated beneficial effects of low-dose corticosteroids in reducing mortality in patients with severe community acquired pneumonia. It is unknown whether these findings apply to low-income settings such as sub-Saharan Africa.This pragmatic randomized-controlled open-label trial will determine the effect of adjunctive low-dose corticosteroids in the management of adults admitted to hospital with community acquired pneumonia on mortality 30-days post-randomization.

Methods: We will enroll and randomize 2180 patients admitted with a diagnosis of community acquired pneumonia into two arms: the control and intervention arm. Those in the control arm will receive standard care for the treatment of community acquired pneumonia i.e., combination therapy with a beta-lactam and macrolide antibiotic. Those in the intervention arm will receive up to 10-days treatment with low-dose oral corticosteroids in addition to standard care. All participants will be followed up to 30- days post randomization and their final status recorded (alive or dead).

Discussion: If adjunctive low-dose oral corticosteroids are found to be beneficial, this easily scalable intervention would significantly reduce the currently high mortality associated with community acquired pneumonia.Pan-African Clinical Trials Registry: PACTR202111481740832; ISRCTRN registry: ISRCTN36138594.

Keywords: Adults; Africa; Mortality; Pneumonia; Pragmatic; Randomized-Controlled Trial; Steroids.

PubMed Disclaimer

Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Map of Kenya showing distribution of SONIA trial sites.
This figure represents the distribution of SONIA trial sites. Eight sites are located in western Kenya, eight around central Kenya and two are at the Kenyan coast.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Lim SS, Vos T, Flaxman AD, et al. : A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60. 10.1016/S0140-6736(12)61766-8 - DOI - PMC - PubMed
    1. Aston SJ, Rylance J: Community-acquired pneumonia in Sub-Saharan Africa. Semin Respir Crit Care Med. 2016;37(6):855–67. 10.1055/s-0036-1592126 - DOI - PubMed
    1. Steel HC, Cockeran R, Anderson R, et al. : Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediators Inflamm. 2013;2013(1): 490346. 10.1155/2013/490346 - DOI - PMC - PubMed
    1. Harris LK, Crannage AJ: Corticosteroids in community-acquired pneumonia: a review of current literature. J Pharm Technol. 2021;37(3):152–60. 10.1177/8755122521995587 - DOI - PMC - PubMed
    1. Stern A, Skalsky K, Avni T, et al. : Corticosteroids for pneumonia. Cochrane Database Syst Rev. 2017;12(12): CD007720. 10.1002/14651858.CD007720.pub3 - DOI - PMC - PubMed

LinkOut - more resources