Methylprednisolone May Cut Treatment Failure in CAP

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Treatment Failure in CAP
Treatment Failure in CAP

(HealthDay News) — For patients with severe community-acquired pneumonia and high initial inflammatory response, methylprednisolone use is associated with decreased treatment failure, according to a study published in the February 17 issue of the Journal of the American Medical Association.

Antoni Torres, MD, PhD, from Hospital Clínic in Barcelona, Spain, and colleagues conducted a double-blind placebo-controlled trial in three Spanish teaching hospitals involving patients with both severe community-acquired pneumonia and a high inflammatory response. Patients were randomized to receive an intravenous bolus of 0.5mg/kg per 12 hours of methylprednisolone or placebo (61 and 59 patients, respectively) for five days, initiated within 36 hours of admission to the hospital.

The researchers found that among patients from the methylprednisolone group there was less treatment failure compared with the placebo group (13 vs. 31%; P=0.02). The risk of treatment failure was reduced with corticosteroid treatment (odds ratio, 0.34). There was no between-group difference in in-hospital mortality (P=0.37). Hyperglycemia occurred in 18 and 12% of patients in the methylprednisolone and placebo groups, respectively (P=0.34).

"If replicated, these findings would support the use of corticosteroids as adjunctive treatment in this clinical population," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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