PlumX Metrics
Embed PlumX Metrics

Corticosteroids in Community-Acquired Bacterial Pneumonia: a Systematic Review, Pairwise and Dose-Response Meta-Analysis

Journal of General Internal Medicine, ISSN: 1525-1497, Vol: 38, Issue: 11, Page: 2593-2606
2023
  • 18
    Citations
  • 0
    Usage
  • 50
    Captures
  • 1
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

Most Recent News

New Findings in Bacterial Pneumonia Described from McMaster University (Corticosteroids In Community-acquired Bacterial Pneumonia: a Systematic Review, Pairwise and Dose-response Meta-analysis)

2023 MAY 25 (NewsRx) -- By a News Reporter-Staff News Editor at Disease Prevention Daily -- Research findings on Lung Diseases and Conditions - Bacterial

Review Description

Introduction: International guidelines provide heterogenous guidance on use of corticosteroids for community-acquired pneumonia (CAP). Methods: We performed a systematic review of randomized controlled trials examining corticosteroids in hospitalized adult patients with suspected or probable CAP. We performed a pairwise and dose-response meta-analysis using the restricted maximum likelihood (REML) heterogeneity estimator. We assessed the certainty of the evidence using GRADE methodology and the credibility of subgroups using the ICEMAN tool. Results: We identified 18 eligible studies that included 4661 patients. Corticosteroids probably reduce mortality in more severe CAP (RR 0.62 [95% CI 0.45 to 0.85]; moderate certainty) with possibly no effect in less severe CAP (RR 1.08 [95% CI 0.83 to 1.42]; low certainty). We found a non-linear dose-response relationship between corticosteroids and mortality, suggesting an optimal dose of approximately 6 mg of dexamethasone (or equivalent) for a duration of therapy of 7 days (RR 0.44 [95% 0.30 to 0.66]). Corticosteroids probably reduce the risk of requiring invasive mechanical ventilation (RR 0.56 [95% CI 0.42 to 74] and probably reduce intensive care unit (ICU) admission (RR 0.65 [95% CI 0.43 to 0.97]) (both moderate certainty). Corticosteroids may reduce the duration of hospitalization and ICU stay (both low certainty). Corticosteroids may increase the risk of hyperglycemia (RR 1.76 [95% CI 1.46 to 2.14]) (low certainty). Conclusion: Moderate certainty evidence indicates that corticosteroids reduce mortality in patients with more severe CAP, the need for invasive mechanical ventilation, and ICU admission.

Bibliographic Details

Provide Feedback

Have ideas for a new metric? Would you like to see something else here?Let us know