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The use of corticosteroids in community acquired pneumonia: a retrospective study in a sample of lebanese adult patients

Abstract

OBJECTIVES: The debate about the efficacy of corticosteroids in the treatment of Community-Acquired Pneumonia (CAP) is still a long-standing dilemma. Accordingly, this study was conducted to evaluate the effect of corticosteroids as an adjunctive therapy on the treatment of CAP in a group of Lebanese adults. The effect of corticosteroids’ administration was appraised using the following indicators: mortality, recurrence, ICU admission and the length of stay in hospital (LOS). METHODS: A retrospective analysis was performed by reviewing all patients files admitted to a Lebanese Hospital between 2012 and 2013. All patients who were on steroids prior to admission or had an indication for steroid use were excluded, except for patients having asthma or COPD. Results were analyzed using Megastat for excel. RESULTS: Patients were mainly with low and moderate mortality risk according to both CURB-65 and the pneumonia severity index (PSI). Patients were categorized into three groups; group 1: CAP patients who were given steroids yet they have no indication, neither COPD nor asthma, for its use (31%), group 2: CAP patients who were given steroids and they have an indication for its use (29.8%), and group 3: CAP patients who had no indication for steroid use and weren’t given steroids (39.2%). Mortality was significantly higher in group 1 when compared to both groups 2 and 3 with p-values <0.02. Recurrence was significantly higher in group 2 when compared to group 1 with a p-value=0.02. As for ICU admission, it was significantly higher in group 1 than in group 3 with a p-value=0.01. Similarly, LOS was significantly longer in group 1 than group 3 with a p-value=0.0028. CONCLUSION: The study results showed that corticosteroids, when given without having an indication for their use, increase mortality, recurrence, ICU admission, and LOS.

Author(s)

Domiati S

Coauthor(s)

Al-Wazzan R, El-Jaroushe W and El-Lakany A

Journal/Conference Information

ACCP Virtual Poster Symposium,38: e85