Adding steroids in severe community-acquired pneumonia treatment: does it make a difference?

Abstract

Background Community-acquired pneumonia (CAP) is the most serious respiratory infection and the leading cause of death from infectious disease around the world. Objective The aim of this study was to evaluate the impact of adjuvant systemic steroids on mortality, complications, and duration of hospitalization in severe CAP. Patients and methods In a cross-sectional, randomized, controlled clinical trial conducted in the Chest Department at the Respiratory Intensive Care Unit during the period between September 2017 and September 2018. Patients were diagnosed as having severe CAP rapidly assessed by infectious disease society of America/American thoracic society (IDSA/ATS) 2007 were included in this study. Results A total of 50 patients were included in this study. These patients were randomly divided into two groups: Group I (steroid group), and group II (control group). The mean age was 55±16.01 and 58.8±20.92 years, respectively. The use of steroids in the treatment of severe CAP is associated with significant improvement in renal, liver, and erythrocyte sedimentation rate parameters with more rapid clinical, radiological, and ultrasonographic resolution. There was a significant reduction in time to clinical stability in group I compared with group II (4.35±1.24 vs 6.54±1.99 days; P=0.02). However, steroid therapy do not affect the duration of ICU stay, need of noninvasive or invasive mechanical ventilation, and duration of hospitalization. Conclusion Adding steroids in severe CAP treatment significantly decreases both complications and mortality.