Published in:
Open Access
01-12-2017 | Research article
Adjunctive corticosteroid therapy for inpatients with Mycoplasma pneumoniae pneumonia
Authors:
Masato Tashiro, Kiyohide Fushimi, Kei Kawano, Takahiro Takazono, Tomomi Saijo, Kazuko Yamamoto, Shintaro Kurihara, Yoshifumi Imamura, Taiga Miyazaki, Katsunori Yanagihara, Hiroshi Mukae, Koichi Izumikawa
Published in:
BMC Pulmonary Medicine
|
Issue 1/2017
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Abstract
Background
There is conflicting evidence regarding the benefit of adjunctive corticosteroid therapy in patients with Mycoplasma pneumoniae pneumonia. We hypothesised that corticosteroid therapy could reduce mortality and length of stay (LOS) in such patients.
Methods
Adult patients with M. pneumoniae pneumonia from January 2010 to December 2013 were identified from the Japanese Diagnosis Procedure Combination inpatient database. The effects of low-dose and high-dose corticosteroid therapies on mortality, LOS, drug costs and hyperglycaemia requiring insulin treatment were evaluated using propensity score analyses.
Results
Eligible patients (n = 2228) from 630 hospitals were divided into no-corticosteroid (n = 1829), low-dose corticosteroid (n = 267) and high-dose corticosteroid (n = 132) groups. The propensity score-matched pairs were generated from no-corticoid and low-dose corticoid groups (251 pairs), or no-corticoid and high-dose corticosteroid groups (120 pairs). Adjunctive corticosteroid therapy did not decrease 30-day mortality. In addition, both low-dose and high-dose corticosteroid therapies were associated with increases in LOS. Furthermore, hyperglycaemia requiring insulin treatment and drug cost increased with corticosteroid use.
Conclusions
Adjunctive treatment with low-dose or high-dose corticosteroids may not be beneficial in M. pneumoniae pneumonia.