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In 2015, results of two randomized trials showed that systemic corticosteroids were beneficial for some hospitalized patients with community-acquired pneumonia (CAP; NEJM JW Gen Med Mar 15 2015 and JAMA 2015; 313:677; NEJM JW Gen Med Mar 1 2015 and Lancet 2015; 385:1511). Now, two new meta-analyses — one by the Cochrane Library, and one by the Infectious Diseases Society of America (IDSA) — address whether CAP patients should receive systemic corticosteroids routinely.
The Cochrane meta-analysis was a trial-level examination of 13 trials (nearly 2000 adult patients). It showed that systemic corticosteroids significantly lowered mortality in patients with severe CAP (8% vs. 13%; number needed to treat, 19) but had no effect on mortality in pa…