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A recent large randomized trial and subsequent meta-analysis demonstrated a survival benefit for systemic corticosteroids in managing severe community-acquired pneumonia (CAP; NEJM JW Gen Med Apr 15 2023 and N Engl J Med 2023; 388:1931), but patients with less-severe disease did not benefit (NEJM JW Gen Med Dec 15 2023 and Clin Infect Dis 2023; 77:1704). In this retrospective cohort study of 11,500 patients with CAP who were admitted to general medicine units in 7 Canadian hospitals, researchers compared outcomes for patients who received systemic corticosteroids (≈10% of patients) and those who did not. Patients admitted to intensive care units and those with chronic lung disease or COVID-19 infection were excluded.
In an adjusted analysis,…