Systemic corticosteroids for community-acquired pneumonia in adults: a systematic review and meta-analysis

Introduction: Community-acquired pneumonia (CAP) is associated with hospitalization rates of 1– 4 per 1000 population, and mortality rates rise to 35% among patients admitted to intensive care.1 Reduction in pulmonary, as well as systemic, inflammatory response with systemic corticosteroids has theoretical appeal as a means of improving outcome from CAP. An observational study has found steroid administration to be associated with decreased mortality in severe CAP.2 Since the most recent systematic review 3, 3 additional randomised controlled trials (RCTs) have been published. Our aim was to evaluate evidence from RCTs investigating the effect of systemic corticosteroids as adjunctive treatment for adults with CAP.