Effect of Corticosteroids on Pneumonia-Related Mortality

Patients with severe pneumonia treated with corticosteroids may experience a significantly reduced mortality rate, according to a study published by the Cochrane Database of Systematic Reviews.

Researchers identified and analyzed 17 randomized controlled trials with a total of 2264 individuals (1954 adults and 310 children) to determine the effect of systemic corticosteroid therapy in adults and children with pneumonia. Individuals treated with an intervention totaled 1122.

Study results demonstrated a significantly lower incidence of all-cause mortality rates in adults treated with corticosteroids compared with the control group (risk ratio [RR], 0.66; 95% CI, 0.47-0.92; I₂ = 0%, fixed-effect model). In 4 trials that examined mortality in nonsevere pneumonia, there was no significant difference between the corticosteroid treatment group and the control group (RR, 0.95; 95% CI, 0.45-2.00; fixed-effect model).

In addition, clinical failure in pediatric patients was significantly lower in children treated with corticosteroids compared with those in the control group (RR, 0.41; 95% CI, 0.24-0.70; I₂ = 25%, fixed effect model).

Researchers concluded that treatment with corticosteroids for pneumonia in children and severe pneumonia in adults was associated with a reduced mortality risk, and therefore should be considered as a treatment option in patients who meet these criteria.

Further, individuals with nonsevere pneumonia may also benefit from corticosteroid therapy; however, there may not be significant survival advantages. Clinicians should use caution in individuals with diabetes because of the known effect of corticosteroids on glucose control.

Reference

Stern A, Sklasky K, Avni T, Carrara E, Leibovici L, Paul M. Corticosteroids for pneumonia (review). Cochrane Database Syst Rev. 2017;12:CD007720.