Steroid treatment may hasten pneumonia patients' recovery and cut their risk of complications, a new review suggests.
Millions of patients will benefit
The findings "should lead to an important change in treatment for pneumonia," lead author Dr Reed Siemieniuk, a physician and graduate student at McMaster University in Hamilton, Canada, said in a university news release.
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"Corticosteroids are inexpensive and readily available around the world. Millions of patients will benefit from this new evidence," he said.
But one expert said a bit more research may be needed first.
"With such modest – though measurable – effects of treatment, a large multi-centre randomised clinical trial," would still be necessary to confirm the new findings and "perhaps justify a change in the standard of care", said Dr Bruce Polsky. He is chair of the department of medicine at Winthrop-University Hospital in Mineola, New York.
In the new study, the international team led by Siemieniuk analysed data from 13 clinical trials involving more than 2,000 patients who were hospitalised with pneumonia.
They found that patients treated with corticosteroids – drugs that include medicines such as cortisone – were discharged from hospital one day sooner than those who didn't receive corticosteroids.
Corticosteroids safe over short periods
Corticosteroid treatment also reduced the need for ventilators to help patients breathe, and the risk of a life-threatening complication called acute respiratory distress syndrome, which fell from 8 percent to 2 percent of patients when the steroids were used.
Overall, the findings suggest that steroid treatment could reduce death rates among pneumonia patients from about 9 percent to 10 percent now, to 5 to 6 percent, according to the study published online in the Annals of Internal Medicine.
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"Corticosteroids over short periods are safe, and we now know that they achieve important benefits in a serious and common medical illness," study senior investigator Dr Gordon Guyatt, a professor of clinical epidemiology and biostatistics at McMaster, said in the news release .
Polsky stressed that many cases of pneumonia won't require powerful steroids.
"Although this is potentially important data, most cases of pneumonia [acquired outside of the hospital] are not so severely ill and are treated in the outpatient setting," he said. "These data would not apply to such patients."
Dr Len Horovitz is a pulmonary specialist at Lenox Hill Hospital in New York City. He noted that corticosteroids are "potent anti-inflammatory" drugs, and "as such, they can address the inflammation associated with pneumonia. They will also benefit patients with associated pulmonary conditions like COPD and asthma."
However, there was one caveat: "Caution [in using steroids] will need to be exercised in patients with diabetes and hypertension," Horovitz said.
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