Corticosteroids for community-acquired pneumonia: time to act!

Djillali Annane,G Umberto Meduri

doi:10.1186/cc6940

Abstract

The use of corticosteroids for the treatment of community-acquired pneumonia has been reported for almost 50 years. A recent systematic analysis of the relevant literature suggested that corticosteroids reduce the critical illness associated with community-acquired pneumonia. There is little doubt that a prolonged administration of a moderate dose of corticosteroids may alleviate the systemic inflammatory response and subsequent organ dysfunction in severe infection. Whether these favorable effects on morbidity may translate into better survival and quality of life needs to be addressed in additional adequately powered randomized controlled trials.

Highlights

In the era of powerful antibiotics, the likelihood of uncontrolled infection and bacterial proliferation has become less significant
Ample evidence has shown that prolonged treatment with a moderate dose of corticosteroids can improve intracellular downregulation of inflammatory cytokine transcription and accelerate the resolution of critical illness [8]
In addition to the above studies, subgroup analyses for patients with community-acquired pneumonia were recently provided from two randomized trials

Summary

Introduction

In the era of powerful antibiotics, the likelihood of uncontrolled infection and bacterial proliferation has become less significant. In the previous issue of Critical Care, Salluh and colleagues [1] suggested evidence-based recommendations for corticosteroid therapy in community-acquired pneumonia. The recent literature has provided strong experimental support for the use of prolonged corticosteroid treatment in pneumonia [9].

Results

Conclusion