Corticosteroids for community-acquired pneumonia: are we still there?

The objective was to determine the association of systemic CTS therapy with treatment failure and 30-day mortality in hospitalized patients with CAP. A retrospective cohort study was performed on patients who were admitted with CAP to pulmonology department of a University Hospital during the year of 2018. The primary exposure was the receipt of CTS and the primary outcome was 30-day mortality. A multivariable conditional logistic regression model was used to estimate the association between adjunct CTS and mortality, considering severity of pneumonia, immunosuppression status and chronic inflammatory lung disease. Of 117 patients with CAP, 43,6% received CTS, 20,5% had underlying asthma or chronic obstructive pulmonary disease (COPD) and 38% presented with wheezing. Treatment failure and mortality was associated with CTS treatment in patients with pneumonia severity index (PSI) score>4 (OR 3.953, CI 1.185-13.188) contrary to the group of patients with PSI<4 (p>0.99). In the subgroup analysis of patients with severe CAP, treatment failure was significant among patients with no history of asthma or COPD (OR 5.77, CI 1.328-25.054) and no association among patients with chronic inflammatory lung disease (p>0.99). Adjunct CTS therapy was associated with treatment failure and mortality among patients with severe CAP who did not have underlying asthma or COPD. Furthermore, CTS did not reduce mortality for patients with non-severe CAP.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research