Use of glucocorticoids in severe community acquired pneumonia

Abstract

INTRODUCTION: Pneumonia is the inflammation of lung parenchyma due to an infectious agent. When
it affects population not admitted in a hospital, it is defined as community acquired pneumonia (CAP).
Severe CAP represents between 3% and 18% of CAP hospitalizations, with a mortality ranging from 21% to 54%. To assess the severity of CAP, pneumonia severity index (PSI) criteria are used. Corticosteroids
are steroid hormones that participate in different processes, regulating inflammation, the inmune system,
as well as the body’s response to stress. Synthetic and semi-synthetic corticosteroids are used in many
pathological processes.
METHODOLOGY: From the presentation of a clinical scenario, a structured question was made and a
bibliographic search was carried out, with the aim of answering the question about whether the use of
adjuvant corticosteroid therapy in patients with severe CAP reduces mortality and the need of mechanical
ventilation or not.
A PubMed search was performed and the article: “Efficacy and safety of glucocorticoids in the treatment
of severe community-acquired pneumonia” was selected.
ARTICLE ANALYSIS: A secondary analysis of data was performed to define values for absolute risk,
relative risk and number necessary to treat of the problem group and control group, considering the variables
mortality and need of mechanical ventilation. The odds ratio was determined with its respective 95%
confidence interval.
FINAL RECOMMENDATION: the use of adjuvant corticotherapy is recommended as a treatment against
severe CAP.