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Critical Care
Published in: Critical Care 3/2008

Open Access 01-06-2008 | Research

The role of corticosteroids in severe community-acquired pneumonia: a systematic review

Authors: Jorge IF Salluh, Pedro Póvoa, Márcio Soares, Hugo C Castro-Faria-Neto, Fernando A Bozza, Patrícia T Bozza

Published in: Critical Care | Issue 3/2008

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Abstract

Introduction

The purpose of this review was to evaluate the impact of corticosteroids on the outcomes of patients with severe community-acquired pneumonia (CAP).

Methods

We performed a systematic MEDLINE, Cochrane database, and CINAHL search (1966 to November 2007) to identify full-text publications that evaluated the use of corticosteroids in CAP.

Results

An initial literature search yielded 109 articles, and 105 studies were excluded after the first analysis. We found four studies eligible for analysis. On the basis of their results, the use of corticosteroids as adjunctive therapy in severe CAP should be categorized as a weak recommendation (two studies) and a strong recommendation (two studies) with either low- or moderate-quality evidence. However, no evidence of adverse outcomes or harm is present in the evaluated studies.

Conclusion

According to the GRADE system, available studies do not support the recommendation of corticosteroids as a standard of care for patients with severe CAP. Further randomized controlled trials with this aim should enroll a larger number of severely ill patients. However, in patients needing corticosteroids, it may be reasonable to conclude that corticosteroid administration is safe in patients with severe infections receiving antimicrobial therapy.
Appendix
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Metadata
Title
The role of corticosteroids in severe community-acquired pneumonia: a systematic review
Authors
Jorge IF Salluh
Pedro Póvoa
Márcio Soares
Hugo C Castro-Faria-Neto
Fernando A Bozza
Patrícia T Bozza
Publication date
01-06-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6922

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