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Title: Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial
Author: Fernández Serrano, Silvia
Dorca i Sargatal, Jordi
Garcia Vidal, Carolina
Fernández Sabé, Núria
Carratalà, Jordi
Fernández-Agüera, Ana
Corominas Sánchez, Mercè
Padrones, Susana
Gudiol i Munté, Francesc
Manresa, Federico
Keywords: Corticosteroides
Pneumònia adquirida a la comunitat
Assaigs clínics
Adrenocortical hormones
Community-acquired pneumonia
Clinical trials
Issue Date: 2011
Publisher: BioMed Central
Abstract: Introduction The benefit of corticosteroids as adjunctive treatment in patients with severe community-acquired pneumonia (CAP) requiring hospital admission remains unclear. This study aimed to evaluate the impact of corticosteroid treatment on outcomes in patients with CAP. Methods This was a prospective, double-blind and randomized study. All patients received treatment with ceftriaxone plus levofloxacin and methyl-prednisolone (MPDN) administered randomly and blindly as an initial bolus, followed by a tapering regimen, or placebo. Results Of the 56 patients included in the study, 28 (50%) were treated with concomitant corticosteroids. Patients included in the MPDN group show a more favourable evolution of the pO2/FiO2 ratio and faster decrease of fever, as well as greater radiological improvement at seven days. The time to resolution of morbidity was also significantly shorter in this group. Six patients met the criteria for mechanical ventilation (MV): five in the placebo group (22.7%) and one in the MPDN group (4.3%). The duration of MV was 13 days (interquartile range 7 to 26 days) for the placebo group and three days for the only case in the MPDN group. The differences did not reach statistical significance. Interleukin (IL)-6 and C-reactive protein (CRP) showed a significantly quicker decrease after 24 h of treatment among patients treated with MPDN. No differences in mortality were found among groups. Conclusions MPDN treatment, in combination with antibiotics, improves respiratory failure and accelerates the timing of clinical resolution of severe CAP needing hospital admission.
Note: Reproducció del document publicat a: doi:10.1186/cc10103
It is part of: Critical Care, 2011, vol. 15, num. 2, p. R96
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ISSN: 1364-8535
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

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