Effect of low-dose systemic steroid therapy on the management of severe community-acquired pneumonia

Abstract

Introduction The rationale behind the study is that as severe pneumonia is associated with local and systemic inflammatory response, the systemic steroid with its anti-inflammatory effect may affect the outcome and prognosis in severe pneumonia. Objective The aim was to assess the effect of systemic steroid on the course and outcomes of severe community-acquired pneumonia (CAP). Patients and methods This study was a prospective, randomized, controlled study conducted on 60 patients, hospitalized with severe CAP. The patients were divided into two groups: a case group undergone usual antibiotic regimen for CAP according to the guidelines plus systemic steroid therapy with prednisolone 0.5 mg/kg daily for 1 week and a control group without any systemic steroids. The primary outcome was the treatment success and duration of hospitalization. Results The treatment was more successful in the case group compared with the control group (93.3 vs. 70.0%, respectively) with statistically significant difference. The mean days of hospitalization, the mean levels of C-reactive protein after treatment, and the mean decline of C-reactive protein levels were significantly lower among the case group. However, there was no significant difference between the two groups as regards mortality. Conclusion Low-dose systemic steroids significantly increase the success of treatment in severe CAP with less days of hospitalization.