Steroid therapy could improve pneumonia outcomes

by Bruce Sylvester: Corticosteroid therapy appears to improve community-acquired pneumonia outcomes, researchers reported on August 11, 2015 in the Annals of Internal Medicine.

“Our study should lead to an important change in treatment for pneumonia,” said lead investigator, Reed Siemieniuk, MD, a physician and graduate student at McMaster University’s Michael G. DeGroote School of Medicine, in Hamilton, Ontario, Canada. “Corticosteroids are inexpensive and readily available around the world. Millions of patients will benefit from this new evidence.”

For this meta-analysis, the researchers gathered data from 13 randomized trials enrolling over 2,000 patients. The studies were retrieved from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through 24 May 2015

The analysis of the pooled data showed that patients with community-acquired pneumonia who received corticosteroids were discharged from hospital one day sooner than untreated patients.

The findings also suggested that corticosteroid treated subjects had less need of mechanical ventilation or a breathing tube than untreated patients, 5 percent vs. 9 percent, respectively.

The rate of acute respiratory distress syndrome was 2 percent in treated subjects and 8 percent in untreated subjects.

The results also suggested a possibly significant reduction in death rates, from 9-10 per cent among untreated patients to 5-6 percent among steroid treated patients.

“Seldom do we see a major advance in treatment of a condition as common as community-acquired pneumonia,” said investigator Gordon Guyatt, MD, 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,” he added.