Systemic corticosteroids reduce need for ICU or mechanical ventilation in patients with community-acquired pneumonia

Clinical Question

Are systemic corticosteroids beneficial for patients hospitalized with community-acquired pneumonia?

Bottom line

This meta-analysis of hospitalized patients with CAP found evidence that systemic corticosteroids reduce the need for ICU admission and mechanical ventilation, and a suggestion that mortality may be reduced in patients with greater disease severity. This is consistent with the findings of the just-reported French randomized controlled trial of patients in the ICU with severe CAP who were treated for 8 to 14 days with intravenous hydrocortisone 200 mg daily. Two of the largest studies set in general medical wards found no benefit to systemic steroids, so for now their use should be limited to patients with severe CAP. 1a

Study design: Meta-analysis (randomized controlled trials)

Funding: Self-funded or unfunded

Setting: Inpatient (any location)


Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

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