Efficacy of corticosteroids as adjunct therapy in the treatment of community-acquired pneumonia: a systematic review and meta-analysis

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Lydia Mukanhaire School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China.++Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Huijie Li Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Zhengyue Fan Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Liping Yang Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Junyang Wang Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Xiaoyu Zong Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.

Lingjian Zhang Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China

Changqing Yang* School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China

Jian Gong* School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, P.R. China++Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, P.R. China.


Abstract

The objective of this study was to systematically evaluate the clinical efficacy of complementary use of corticosteroids in the treatment of community-acquired pneumonia (CAP). We searched all relevant documents in 5 scientific databases from inception to June 2022 to collect Clinical Trials: Randomized Controlled Trials (RCTs) and Controlled Trials (CT’s) reporting on the adjunct use of corticosteroids when treating CAP. The primary outcome was mortality, and secondary outcomes included the time to clinical stability, therapeutic efficacy, duration of antibiotic treatment and length of hospital/ICU stay. Therapeutic efficacy was defined as the rate of achieving clinical recovery with no fever, improvement, or disappearance of cough, and clinical stability was the improvement in laboratory values. Two researchers independently screened literature according to the inclusion and exclusion criteria, extracted data and evaluated the quality of literature. Statistical analysis and Meta-analysis of intervention measures and indicators were performed using IBM SPSS and RevMan 5.4 software. Nine RCTs comprising of 2673 participants with CAP were identified and included in this study -1335 patients in the corticosteroid group and 1338 patients in the control group. The mean cumulative corticosteroid dose and treatment duration were 298.00±287.140mg and 5.22±1.787 days respectively. Corticosteroid treatment was not associated with a significant reduction in mortality (RR; 95% CI,0.96[ 0.67-1.38], P=0.83). Due to a low number of included patients in our study, more studies with larger sample sizes and high-quality randomized, double-blind controlled trials are needed to confirm this result.

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Clinical Trials*, General Medical Research
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  • 04 Jan 2023 15:10 Version 1
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