Abstract
BackgroundThere is conflicting evidence regarding the benefit of adjunctive corticosteroid therapy in patients with Mycoplasma pneumoniae pneumonia. We hypothesised that corticosteroid therapy could reduce mortality and length of stay (LOS) in such patients.MethodsAdult patients with M. pneumoniae pneumonia from January 2010 to December 2013 were identified from the Japanese Diagnosis Procedure Combination inpatient database. The effects of low-dose and high-dose corticosteroid therapies on mortality, LOS, drug costs and hyperglycaemia requiring insulin treatment were evaluated using propensity score analyses.ResultsEligible patients (n = 2228) from 630 hospitals were divided into no-corticosteroid (n = 1829), low-dose corticosteroid (n = 267) and high-dose corticosteroid (n = 132) groups. The propensity score-matched pairs were generated from no-corticoid and low-dose corticoid groups (251 pairs), or no-corticoid and high-dose corticosteroid groups (120 pairs). Adjunctive corticosteroid therapy did not decrease 30-day mortality. In addition, both low-dose and high-dose corticosteroid therapies were associated with increases in LOS. Furthermore, hyperglycaemia requiring insulin treatment and drug cost increased with corticosteroid use.ConclusionsAdjunctive treatment with low-dose or high-dose corticosteroids may not be beneficial in M. pneumoniae pneumonia.
Highlights
There is conflicting evidence regarding the benefit of adjunctive corticosteroid therapy in patients with Mycoplasma pneumoniae pneumonia
Corticosteroids have been shown to exert a beneficial effect in severe cases of M. pneumoniae infection via downregulation of cell-mediated immune responses associated with the pulmonary injury that occurs during the infection [15,16,17,18]
Patients A total of 2718 patients with M. pneumoniae pneumonia were admitted to 690 hospitals from January 2010 to December 2013
Summary
There is conflicting evidence regarding the benefit of adjunctive corticosteroid therapy in patients with Mycoplasma pneumoniae pneumonia. Most cases of M. pneumoniae pneumonia are mild and self-limiting; some result in fulminant respiratory failure and may be fatal [4,5,6,7,8]. A previous study reported a mortality rate of 29.4% among patients with M. pneumoniae pneumonia who required intensive care unit (ICU) admission [9]. Evidence is limited to case reports and small case series. The results of studies in patients with severe CAP suggest that short-term, late-phase, high-dose corticosteroid treatment is not beneficial [19,20,21,22]. Other studies have reported the efficacy of high-dose methylprednisolone
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
