Adjunctive Steroids for Severe CAP: Not Yet, and Not for All

Among patients with severe community-acquired pneumonia and high inflammatory response, steroid-group patients were less likely to experience treatment failure than placebo-group patients.

Several studies have assessed the potential benefits of adjunctive steroids for treatment of community-acquired pneumonia (CAP; NEJM JW Infect Dis Mar 2015 and Lancet 2015 Jan 18; [e-pub]). In this trial, conducted at three teaching hospitals in Spain, investigators randomized adults with severe CAP and a high inflammatory response (C-reactive protein level >150 mg/L) to receive intravenous methylprednisolone 0.5 mg/kg or placebo every 12 hours for 5 days. Exclusion criteria included severe immunosuppression, nosocomial pneumonia, uncontrolled diabetes, H1N1 infection, and prior steroid treatment. The primary endpoint was treatment failure — a composite that included clinical outcomes (e.g., shock, mechanical ventilation, or death) and radi…

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Adjunctive Steroids for Severe CAP: Not Yet, and Not for All

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Reviewing Author