[Treatment of aspiration pneumonia with low-dose methylprednisolone and antibiotics]

Abstract

Low-dose methylprednisolone and antibiotics were used to treat 30 patients with aspiration pneumonia, in a prospective, randomized, double-blind trial with placebo control. All patients received clindamycin phosphate 1200 mg per day. In addition, 15 patients received methylprednisolone 20 mg per day for three days and the other 15 patients received placebo according to the same schedule. In the methyl prednisolone group, CRP had decreased (p < 0.05) from 12.7 +/- 9.8 to 6.4 +/- 5.4 mg/dl day 4, neutrophil elastase had decreased (p < 0.05) from 402 +/- 304 to 231 +/- 64 micrograms/dl by day 4 and to 184 +/- 59 micrograms/dl by day 7, maximum body temperature had decreased (p < 0.01) from 37.9 +/- 1.1 to 36.8 +/- 0.6 degrees C by day 7, and the pneumonia score had improved (p < 0.01) from 11.8 +/- 3.0 to 8.6 +/- 2.4 by day 4. In the placebo group, there were no significant improvements by those days. We conclude that low-dose methylprednisolone therapy with antibiotics is effective against aspiration pneumonia.