More Evidence That Steroids Are Beneficial in Community-Acquired Pneumonia

I previously recommended glucocorticoid therapy for patients admitted with severe community-acquired pneumonia (CAP), based on a meta-analysis of studies of all comers with CAP, which found a decreased incidence of acute respiratory distress syndrome (ARDS) but no mortality benefit (NEJM JW Emerg Med Dec 2015 and Chest 2016; 149:209). Now investigators report findings of a meta-analysis of randomized, controlled trials of adjuvant glucocorticoid therapy in patients with severe CAP.

Ten trials including 729 patients with severe CAP met the criteria. Of these, three were considered good quality, seven fair, and one poor. All patients received standard therapy, including antibiotics, and were randomized to the addition of glucocorticoids. Type …