Steroid Therapy Reduces Mortality, Hospital Stay for Patients With Pneumonia

The use of systemic corticosteroid therapy could reduce mortality for hospitalized adults with community-acquired pneumonia, according to research published in the Annals of Internal Medicine.

The investigators used data from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials and determined that patients hospitalized with community-acquired pneumonia benefited in multiple ways from the use of corticosteroids.

All-cause mortality fell from about 9% to 5% with the use of this therapy, which also was associated with a reduction in need for mechanical ventilation (by 5%), and acute respiratory distress syndrome. Corticosteroids also decreased time to clinical stability and duration of hospitalization by 1 day for these patients.

“Our study should lead to an important change in treatment for pneumonia,” lead author Reed A.C. Siemieniuk, MD, a physician and a graduate student at McMaster University, said in a statement. “Corticosteroids are inexpensive and readily available around the world. Millions of patients will benefit from this new evidence.”

Lower respiratory infections are the second-most common cause of premature mortality around the world, and community-acquired pneumonia is common in developed countries and can be severe as it is associated with acute respiratory distress syndrome and requires mechanical ventilation.

The international group of researchers (from Canada, Spain, Switzerland, and Norway) analyzed 13 randomized trials that included more than 2000 patients.

“Seldom do we see a major advance in treatment of a condition as common as community-acquired pneumonia,” said Gordon Guyatt, MD, MSc, the study’s senior investigator and a professor of clinical epidemiology and biostatistics at McMaster University. “Corticosteroids over short periods are safe, and we now know that they achieve important benefits in a serious and common medical illness.”