Review article
https://doi.org/10.37797/ig.39.4.3
Corticosteroids in severe pneumonia
Viktor Kotarski
; Klinika za infektivne bolesti “Dr. Fran Mihaljević”, Zagreb, Hrvatska
Abstract
Community acquired pneumonia (CAP) remains a significant cause of morbidity and mortality despite appropriate antimicrobial treatment. Treatment failure is, at least in part, caused by excessive inflammatory response to infection. Corticosteroids have been proven effective in improving treatment outcomes in several infectious diseases. With this rationale, many studies have been conducted to determine whether the immunomodulatory effect of steroids would also be beneficial in treatment of CAP. Although many studies did demonstrate shorter time to clinical stability, shorter antimicrobial treatment, and shorter hospitalization, most of them have failed to demonstrate survival benefit. Generally speaking, the latest guidelines for treatment of CAP (published in 2019 by IDSA and NICE, respectively) do not recommend the routine use of corticosteroids, but some experts still recommend their use in case of severe CAP. Further studies are needed to determine which groups of patients are most likely to benefit from corticosteroids and what are the optimal dose and duration of treatment.
Keywords
Hrčak ID:
240693
URI
Publication date:
7.7.2020.
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