A meta-analysis published in Crit_Care finds that in patients with severe community-acquired pneumonia, adjunctive corticosteroids can provide survival benefits and improve clinical outcomes without increasing adverse events. Further studies are required.
]. Overall, these findings suggest that systemic corticosteroids are generally safe for use in the treatment of sCAP; however, glucose levels should be closely monitored and appropriate management strategies should be implemented to mitigate the risk of hyperglycemia.
The current meta-analysis has several strengths. First, we focused only on sCAP to avoid the confounding effects of disease severity. In addition, the low heterogeneity in most outcomes, which may be attributed to similar infection types and patient characteristics among the included studies, may indicate a low risk of bias.
This study has several limitations. First, the number of studies focusing on the adjunctive use of corticosteroids in patients with sCAP is limited, which may contribute to the inconclusive evidence regarding the survival benefit and safety of TSA. Secondly, it is noteworthy that the definitions of sCAP employed in each included RCTs were not the same. However, our subgroup analysis of these variations displayed a similar trend.
In conclusion, the current meta-analysis showed that systemic corticosteroids can provide additional survival and other clinical benefits, including a lower risk of MV use and shorter ICU and hospital stays in the treatment of patients with sCAP. In addition, adjunctive corticosteroids did not increase the AEs such as GI tract bleeding, HIA, and AKI in this clinical entity.
Belgique Dernières Nouvelles, Belgique Actualités
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