Previous Inhaled Corticosteroid Use Decreases Likelihood of Pleural Effusion in CAP

In an observational study involving 3612 patients with community-acquired pneumonia, pleural effusion and empyema occurred significantly less frequently in those with previous use of inhaled corticosteroids.

Patients with chronic obstructive lung disease (COPD) who routinely use inhaled corticosteroids (ICS) are at increased risk for community-acquired pneumonia (CAP). However, studies suggest that for COPD patients who develop CAP, previous ICS use is associated with decreased mortality and decreased incidence of parapneumonic effusion (PPE) and empyema.

To examine this paradox, investigators conducted a prospective observational study involving consecutive immunocompetent adults treated for CAP at a Barcelona hospital between 1997 and 2008. Among these 3612 patients, 390 (11%) developed PPE. The incidence of PPE was significantly lower in previous ICS users than in nonusers (5% vs. 12%; P<0.001), as was the incidence of empyema (0.5 vs. 2%; P=…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Previous Inhaled Corticosteroid Use Decreases Likelihood of Pleural Effusion in CAP

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Reviewing Author