Corticosteroids May Speed Pneumonia Recovery in Some

Adding dexamethasone to antibiotic regimen helps treat community-acquired pneumonia, study says

TUESDAY, May 31 (HealthDay News) -- Patients with an inflammatory lung condition known as community-acquired pneumonia appear to recover faster when treated with corticosteroids in addition to the standard regimen of antibiotics, Dutch researchers say.

Those treated with a combination of corticosteroids and antibiotics also required a shorter hospital stay than patients treated with antibiotics alone, the study authors found.

The observations stem from what is believed to be the largest study to date focused on the potential of corticosteroids for the treatment of community-acquired pneumonia, or CAP.

Dr. Sabine Meijvis, from the St. Antonius Hospital in Nieuwegein, the Netherlands, and colleagues reported their findings in the May 31 online edition of The Lancet.

Meijvis and her team noted that, currently, CAP is typically treated with antibiotics following an early diagnosis.

To explore whether corticosteroids might reduce the risk for complications and fatalities, the team focused on just over 300 Dutch CAP patients. Half of the patients were placed on a standard antibiotic protocol coupled with 5 milligrams a day of the corticosteroid dexamethasone. The other half were given antibiotics plus a placebo (an inactive treatment).

After four days, the research team found that those given the corticosteroid experienced less lung inflammation, and recovered more quickly than those who were just given antibiotics.

The corticosteroid group also required one less day of hospitalization than the antibiotic group (6.5 days versus 7.5 days). In addition, by the end of one month, the corticosteroid group had experienced better "social functioning" relative to the antibiotic group, the investigators found.

"Serious adverse events were rare" among the corticosteroid group, the study team noted in a journal news release, while at the same time cautioning that "the benefits of corticosteroids should be weighed against the potential disadvantages of these drugs, such as superinfections and gastric disturbances."

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said the findings were in line with what he might expect.

"It doesn't surprise me because corticosteroids are used as nuclear anti-inflammatories," he said, noting they might suppress an otherwise lingering fever within 24 hours. "And they would mask a lot of symptoms and make a patient feel generally better whether they're asthmatics or have some inflammatory disease."

"But the downside," he cautioned, "is that we know that corticosteroids are immune-suppressive. And so the possibility exists that when you use them, you could be prolonging the actual recovery time even as you are masking the symptoms, although this study doesn't say that."

This is a potential danger for otherwise healthy people and especially so for those who have high blood pressure or diabetes, he said. "So any medication is a double-edged sword," he added. "And the use of corticosteroids in this case has to be weighed against possible complications."

More information

For more on pneumonia, visit the U.S. National Library of Medicine.

Alan Mozes SOURCE: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City, and Northshore-LIJ Health System; The Lancet, news release, May 31, 2011

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