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Community-acquired pneumonia (CAP) remains a leading cause of mortality in the U.S. Early, appropriate antibiotics are essential, as are supplemental oxygen and mechanical ventilatory support, when needed. For many years, clinicians have wondered if glucocorticoids also could be beneficial because of their anti-inflammatory properties.
In a study published in 2023, French investigators randomized 800 patients with severe CAP to receive either intravenous hydrocortisone (200 mg daily) or placebo. All patients were admitted to the intensive care unit (ICU) and began treatment within 24 hours of developing severe CAP. Nearly half the patients were supported with high-flow oxygen, and one quarter were intubated at enrollment. In this critically …