[The indications for glucocorticoids in treating community-acquired pneumonia in adults: a meta-analysis].
OBJECTIVE
Community acquired pneumonia (CAP) is a common pulmonary infectious disease. Glucocorticoids (GCS) as one of the most powerful anti-inflammation drugs, are still the most controversial adjuvant therapy in treating CAP. Which sub-groups of CAP patients would benefit from GCS is a debating topic. Our aim of this study is to find the indications for GCS in treating adult CAP patients by using meta-analysis.


METHODS
"Steroids, glucocorticoids, corticosteroids, hydrocortisone, prednisone, cortisol, methylprednisolone, dexamethasone"and"community-acquired pneumonia"were used as key words both in Chinese and English to search all published literature in Pubmed, EMBASE MEDLINE, Cochrane, CNKI and Wanfang Database until March 2015.


RESULTS
All 840 articles were reviewed, and 11 high quality randomized clinical trials involving 1942 adult CAP patients were included in this meta-analysis. Using GCS did not significantly reduce mortality in all CAP patients (OR=0.68, 95%CI 0.46-0.99, P=0.04). But in the subgroup analysis, patients with severe CAP benefited from GCS treatment (OR=0.35, 95%CI 0.17-0.75, P=0.007). GCS also increased the risk of hyperglycemia (OR=1.99, 95%CI 1.50-2.65, P<0.000 01).


CONCLUSIONS
RESULTS from this meta-analysis suggested that GCS should only be rigorously used in severe CAP patients.
Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing 100730, China.
X L
XL
Tian
M
M
Jiang
X F
XF
Sun
Y Z
YZ
Zhan
S B
SB
Wang
S S
SS
Kang
D000328:Adult; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011014:Pneumonia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D005938:Glucocorticoids