Prior Corticosteroid Treatment Worsens Outcomes in ICU-Acquired Pneumonia

Treatment with systemic corticosteroids is common in critically ill patients. However, these agents interfere with immune response and thus alter the dynamics and course of infections. Little is known about outcomes in intensive care unit (ICU) patients who receive corticosteroids and subsequently develop pneumonia.

To explore this issue, researchers prospectively collected data on consecutive adults who developed pneumonia ≥48 hours after admission to an ICU in Barcelona, Spain, between January 2007 and January 2011. Among these 316 patients, 125 (40%) had received systemic corticosteroids at a methylprednisolone equivalent dosage of ≥20 mg/day within 2 days of pneumonia onset (median duration of corticosteroid treatment, 6 days; average da…