Efficacy of adjunctive corticosteroid therapy in severe community acquired pneumonia (SCAP) at a tertiary care hospital in Pakistan
DOI:
https://doi.org/10.61581/mjsp.v6i3.358Keywords:
Corticosteroids, Community aquired pneumonia, Efficacy, PulmonologyAbstract
Objective: To determine the adjunctive corticosteroid therapy in severe community acquired pneumonia (SCAP) at a tertiary care hospital in Pakistan.
Methods: A randomized controlled trial was conducted at department of Pulmonology, Gujranwala Medical College / DHQ Gujranwala from 07-11-2024 to 06-05-2025. Sixty patients admitted in the department of pulmonologywere selected and divided into two groups. Group-A received only antimicrobial therapy and group-S received antimicrobial and 40?mg/day prednisone for 7 days as adjunctive therapy. Baseline data was recorded. Duration of antibiotics and hospital stay were also documented. Re-evaluation was done at seventh day of treatment and efficacy was assessed.Data was analyzed through SPSS version 25. Student t-test, chi square test or Fisher’s Exact test were applied. P ?0.05 was taken as statistically significant.
Results: Duration of antibiotics therapy and hospitalization were significantly shorter in the steroid group (10.60±1.59 vs. 14.83±3.79 days, p<0.001; 11.43±2.03 days vs. 13.93±3.77 days, p=0.003, respectively). The outcome was better in the steroids group as compared to the antibiotics alone group (70% vs. 43.3%, p= 0.037).
Conclusion: The use of corticosteroids has a beneficial role in improving the outcome and reducing the hospital stay among the elderly patients of severe community acquired pneumonia.
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1. Mukanhaire L, Wang J, Zong X, Zhang L, Zhou X, Gong J. Recent advances in efficacy of corticosteroids as adjunct therapy for the treatment of community-acquired pneumonia in children: a systematic review and meta-analysis. medRxiv. 2022:2022-04.
2. Mukanhaire L, Li H, Fan Z, Yang L, Zheng Y, Ran Z, et al. Efficacy of corticosteroids as an adjunctive therapy in the treatment of community-acquired pneumonia: a systematic review and meta-analysis. Acta Mater Med. 2023: 2(1):9-22.
3. Bielicki JA, Stöhr W, Barratt S, Dunn D, Naufal N, Roland D, et al. Effect of amoxicillin dose and treatment duration on the need for antibiotic re-treatment in children with community-acquired pneumonia: the CAP-IT randomized clinical trial. Jama. 2021;326(17):1713-24.
4. Ferreira-Coimbra J, Sarda C, Rello J. Burden of community-acquired pneumonia and unmet clinical needs. Adv Ther. 2020 Apr;37: 1302-18.
5. Wang Z, Ji Y, Zhang J, Su K, Fan HB, Yang WW, et al. Investigation on Atypical Pathogens related with Community Acquired Pneumonia and the Factors Associated with Mycoplasma Pneumoniae Infection in Jiangsu, China. Clin Lab. 2020;66(6);1073-81.
6. Hassen M, Toma A, Tesfay M, Degafu E, Bekele S, Ayalew F, et al. Radiologic diagnosis and hospitalization among children with severe community acquired pneumonia: a prospective cohort study. BioMed Res Int. 2019: 6202405.
7. Ye Z, Wang Y, Colunga-Lozano LE, Prasad M, Tangamornsuksan W, Rochwerg B, et al. Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis. CMAJ. 2020;192(27):E756-67.
8. Jiang S, Liu T, Hu Y, Li R, Di X, Jin X, et al. Efficacy and safety of glucocorticoids in the treatment of severe community-acquired pneumonia: a meta-analysis. Medicine. 2019; 98(26): e16239.
9. Martin-Loeches I, Torres A. New guidelines for severe community-acquired pneumonia. Curr OpinPulm Med. 2021;27(3):210-15.
10. Vasconcelos MK, Sauteur PM, Santoro R, Coslovsky M, Lurà M, Keitel K, et al. Randomised placebo-controlled multicentre effectiveness trial of adjunct betamethasone therapy in hospitalised children with community-acquired pneumonia: a trial protocol for the KIDS-STEP trial. BMJ Open. 2020;10(12): e041937.
11. Shakeel S, Iffat W, Qamar A, Ghuman F, Yamin R, Ahmad N, et al. Pediatricians’ compliance to the clinical management guidelines for community-acquired pneumonia in infants and young children in Pakistan. Health Care 2021;9(6);701.
12. Wafy S, Bayoumi H, El-Naser SA. Adding steroids in severe community-acquired pneumonia treatment: does it make a difference? Egypt J Chest Dis Tuberc. 2021;70(1):71-7.
13. Garcia-Vidal C, Calbo E, Pascual V, Ferrer C, Quintana S, Garau J. Effects of systemic steroids in patients with severe community-acquired pneumonia. EurRespir J. 2007;30(5):951-6.
14. Dequin PF, Meziani F, Quenot JP, Kamel T, Ricard JD, Badie J, et al. Hydrocortisone in severe community-acquired pneumonia. N Eng J Med. 2023;388(21):1931-41.
15. Wittermans E, Vestjens SM, Spoorenberg SM, Blok WL, Grutters JC, Janssen R, 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.
16. Nafae RM, Ragab MI, Amany FM, Rashed SB. Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia. Egypt J Chest DisTuberc. 2013;62(3):439-45.
17. Gu X, Yang P, Yu L, Yuan J, Zhang Y, Yuan Z, Chen L, Zhang X, Chen Q. Glucocorticoids can reduce mortality in patients with Severe community-acquired pneumonia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. https://doi.org/10.21203/rs.3.rs-3576792/v1
18. Saleem N, Kulkarni A, Snow TA, Ambler G, Singer M, Arulkumaran N. Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia: a systematic review, meta-analysis, and meta-regression of randomized control trials. Chest. 2023;163(3):484-97.
19. Harris LK, Crannage AJ. Corticosteroids in community-acquired pneumonia: a review of current literature. J Pharm Technol. 2021;37(3):152-60.
20. Cheema HA, Musheer A, Ejaz A, Paracha AA, Shahid A, Rehman ME, et al. Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials. J Crit Care. 2024;80:154507.
21. Bergmann F, Pracher L, Sawodny R, Blaschke A, Gelbenegger G, Radtke C, 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;77(12):1704-13.
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Copyright (c) 2025 Asad Iqbal Khan, Muhammad Younus, Asim Saleem Sheikh, Abdullah Khalid, Ali Raza, Hanzala

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