Ah, steroids. Can’t live with them, can’t live without them. Rheumatology, immunology, and countless other specialties rely on them, but their anti-inflammatory effects may become even more useful, especially when it comes to community acquired pneumonia.
Early antibiotic treatment for proven community acquired pneumonia lowers mortality and length of stay, along with analgesia, chest physiotherapy and so forth. This study from the Lancet out of the Netherlands looked at giving dexamethasone, IV at a dose of 5mg, for 4 days to those with pneumonia.
Length of stay dropped by a day, but mortality and severe adverse events didn’t differ (although the numbers may have been too small to detect a difference). Hyperglycaemia was about twice as common in the dex group though, which could be an issue.
Check this one out here – a bigger study may be coming soon to prompt a guideline change. Questions also arise about the usefulness in more severe patients, and whether similar outcomes are seen in those already on steroids.
IMAGE Pulmonary Pathology