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Mortality associated with community-acquired pneumonia (CAP) decreased sharply after the introduction of antibiotics in the 1940s, but no further reductions have occurred. Recent data suggest that an excessive host inflammatory response is associated with worse outcomes, but whether steroids attenuate inflammatory responses and improve outcomes for patients with CAP is unclear. Researchers examined the effect of steroid therapy in adults with CAP in a systematic review of eight randomized, controlled trials (involving >1100 patients).
The overall quality of evidence was moderate. Adjunctive steroid therapy had no significant effect on in-hospital mortality or intensive care unit (ICU) length of stay (LOS), but it did shorten overall hospital…