title: Efficacy of methylprednisolone in children with severe community acquired pneumonia.
abstract: BACKGROUND
  The clinical value of adjuvant corticosteroid treatment in community-acquired pneumonia (CAP) seemed to be controversial in adults, and even less data are available on the use of corticosteroids in children with CAP.
  
  
  METHODS
  In this study, we investigated the efficacy of a 5-day adjuvant methylprednisolone therapy to imipenem in 29 children with severe CAP. In parallel, 30 subjects with the same disease were treated with imipenem and placebo, and the two study groups were compared based on the different parameters of the primary and secondary end points. The primary end points were the duration of fever, the levels of white blood cells (WBC) and high sensitive C-reactive protein (hsCRP). Secondary end points were the length of hospital stay, and the number of severe complications with or without surgical interventions.
  
  
  RESULTS
  The additive methylprednisolone treatment significantly reduced the duration of fever with 2.5 days, the WBC counts (P = 0.014), the hsCRP levels showing a 48.7% decrease, and the length of hospital stay with 5.2 days versus the placebo group. Moreover, patients treated on imipenem alone had twice more complications and four times more invasive interventions compared to those on the combined therapy.
  
  
  CONCLUSIONS
  The 5-day methylprednisolone therapy with imipenem was found effective in children having severe CAP. However, trials with larger cohorts are needed to study further beneficial effects of corticosteroids in children with CAP.
authors.affiliation: Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. bnagy@dote.hu
authors.forename: Bela
authors.initials: B
authors.lastname: Nagy
authors.forename: Imre
authors.initials: I
authors.lastname: Gaspar
authors.forename: Agnes
authors.initials: A
authors.lastname: Papp
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Bene
authors.forename: Bela
authors.initials: B
authors.lastname: Nagy
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Voko
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Balla
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D007223:Infant; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D011014:Pneumonia / Q000097:blood / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D015378:Imipenem; D002097:C-Reactive Protein; D008775:Methylprednisolone