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BACKGROUND: Community-acquired pneumonia(CAP) is pneumonia acquired infectiously from normal social contact as opposed to being acquired during hospitalization. CAP is a leading cause of illness and death. This review aims to determine the efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia(CAP).DATA SOURCES: We searched randomized controlled trials(RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, and Chinese Biomedical Literature Database to obtain the information by using steroids, glucocorticoids, cortisol, corticosteroids, community-acquired pneumonia and CAP as key words. The quality of RCTs was evaluated. A Meta-analysis was made using Rev Man 5.0 provided by the Cochrance Collaboration.RESULTS: Seven RCTs involving 944 patients were included in the meta-analysis. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in standard treatment group(WMD=–1.70, 95%CI 2.01–1.39, Z=10.81, P<0.00001). No statistically significant differences were found in the mortality rate(RR=0.77,95%CI 0.46–1.27, Z=1.03, P=0.30), the mean length of hospital stay in ICU(WMD=1.17, 95%CI 1.68–4.02, Z=0.81, P=0.42), the incidence of super infection(RR=1.32, 95%CI 0.66–2.63, Z=0.79, P=0.43), the incidence of hyperglycemia(RR=1.84, 95%CI 0.76–4.41, Z=1.36, P=0.17), the incidence of upper gastrointestinal bleeding(RR=1.98, 95%CI 0.37–10.59, Z=0.80, P=0.42) between the standard treatment group and the glucocorticoids treatment group.CONCLUSIONS: The use of glucocorticoids in patients with community-acquired pneumonia can significantly shorten the duration of illness and have a favorable safety profile. However, it could not reduce the overall mortality.
BACKGROUND: Community-acquired pneumonia (CAP) is pneumonia acquired infectiously from normal social contact as opposed to being acquired during hospitalization. This review aims to determine the efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia (CAP). DATA SOURCES: We searched randomized controlled trials (RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, and Chinese Biomedical Literature Database to obtain the information by using steroids, glucocorticoids, cortisol The quality of RCTs was evaluated as made using Rev Man 5.0 provided by the Cochrane Collaboration. RESULTS: Seven RCTs involving 944 patients were included in the meta-analysis . The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in standard treatment group (WMD = -1.70, 95% CI 2.01-1.39, Z = 10.81, P <0.00001). No statistically significant differences were found in the mortality rate (RR = 0.77, 95% CI 0.46-1.27, Z = 1.03, P = 0.30) the incidence of super infection (RR = 1.32, 95% CI 0.66-2.63, Z = 0.79, P = 0.43) in the ICU (WMD = 1.17, 95% CI 1.68-4.02, Z = 0.81, P = 0.42) incidence of hyperglycemia (RR = 1.84, 95% CI 0.76-4.41, Z = 1.36, P = 0.17) between the standard treatment group and the glucocorticoids treatment group. CONCLUSIONS: The use of glucocorticoids in patients with community-acquired pneumonia can significantly shorten the duration of illness and have a favorable safety profile. However, it could not reduce the overall mortality.