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As many as 20% of patients with community-acquired pneumonia (CAP) worsen despite guideline-adherent antimicrobial therapy. Systemic corticosteroids might reduce cytokine and inflammatory responses that can lead to some CAP treatment failures. In 2015, researchers published two new randomized, controlled trials in which systemic corticosteroids were evaluated in hospitalized CAP patients.
A Spanish trial of 120 patients with severe CAP who received steroids showed that these patients were significantly less likely to experience a multicomponent treatment-failure endpoint that included both adverse clinical outcomes (mechanical ventilation, shock, death) and radiographic progression (13% vs. 31%); when the radiographic outcome was excluded, a…