Download from app store
We have detected that you are using an Ad Blocker.
PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
Please provide your AHPRA Number to ensure that you are given the correct level of access to our site.
Published in Respiratory Medicine

Expert Opinion / Commentary · December 14, 2023

2023 Top Story in Respiratory Medicine: Steroid Use in Community-Acquired Pneumonia

Written by
Virginia A. Brady MD


Additional Info

  1. Kyu HH, Vongpradith A, Sirota SB, et al. Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis. 2022;22(11):1626-1647.
  2. Ramirez JA, Wiemken TL, Peyrani P, et al. Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality. Clin Infect Dis. 2017;65(11):1806-1812.
  3. Liapikou A, Ferrer M, Polverino E, et al. Severe Community‐Acquired Pneumonia: Validation of the Infectious Diseases Society of America/American Thoracic Society Guidelines to Predict an Intensive Care Unit Admission. Clin Infect Dis. 2009;48(4):377-385.
  4. Cavallazzi R, Wiemken T, Arnold FW, et al. Outcomes in patients with community-acquired pneumonia admitted to the intensive care unit. Respir Med. 2015;109(6):743-750.
  5. Kochanek KD, Murphy SL, Xu J, Arias E. Natl Vital Stat Rep. Deaths: Final Data for 2020. 2023 Sep;72(10):1-92.
  6. Snijders D, Daniels JMA, De Graaff CS, et al. Efficacy of Corticosteroids in Community-acquired Pneumonia: A Randomized Double-Blinded Clinical Trial. Am J Respir Crit Care Med. 2010;181(9):975-982.
  7. Meijvis SC, Hardeman H, Remmelts HH, et al. Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. Lancet. 2011;377(9782):2023-2030.
  8. Fernández-Serrano S, Dorca J, Garcia-Vidal C, et al. Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial. Crit Care. 2011;15(2):R96.
  9. Blum CA, Nigro N, Briel M, et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2015;385(9977):1511-1518.
  10. Torres A, Sibila O, Ferrer M, et al. Effect of Corticosteroids on Treatment Failure Among Hospitalized Patients With Severe Community-Acquired Pneumonia and High Inflammatory Response: A Randomized Clinical Trial. JAMA. 2015;313(7):677-686.
  11. Wittermans E, Vestjens SMT, Spoorenberg SMC, et al. Adjunctive treatment with oral dexamethasone in non-ICU patients hospitalised with community-acquired pneumonia: a randomised clinical trial. Eur Respir J. 2021;58(2):2002535.
  12. Confalonieri M, Urbino R, Potena A, et al. Hydrocortisone Infusion for Severe Community-acquired Pneumonia: A Preliminary Randomized Study. Am J Respir Crit Care Med. 2005;171(3):242-248.
  13. Chen Y, Li K, Pu H, Wu T. Corticosteroids for pneumonia. Cochrane Database Syst Rev. 2011;(3): CD007720.
  14. Briel M, Spoorenberg SMC, Snijders D, et al. Corticosteroids in Patients Hospitalized With Community-Acquired Pneumonia: Systematic Review and Individual Patient Data Metaanalysis. Clin Infect Dis. 2018;66(3):346-354.
  15. Stern A, Skalsky K, Avni T, et al. Corticosteroids for pneumonia. Cochrane Acute Respiratory Infections Group, ed. Cochrane Database Syst Rev. 2017;2017(12):CD007720.
  16. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67.
  17. The Corticosteroid Guideline Task Force of SCCM and ESICM, Pastores SM, Annane D, Rochwerg B. Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part II): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Intensive Care Med. 2018;44(4):474-477.
  18. Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941.
  19. Meduri GU, Shih MC, Bridges L, et al. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. 2022;48(8):1009-1023.
  20. Bergmann F, Pracher L, Sawodny R, et al. Efficacy and Safety of Corticosteroid Therapy for Community-Acquired Pneumonia: A Meta-Analysis and Meta-Regression of Randomized, Controlled Trials. Clin Infect Dis. 2023 Oct 25: doi: 10.1093/cid/ciad496. Online ahead of print.

Disclosure statements are available on the authors' profiles:

Further Reading