Steroids beneficial in severe pneumonia

Adding a steroid to standard antibiotic therapy can significantly decrease the mortality in people suffering from severe pneumonia. Mild pneumonia is usually associated with the atypical organisms Mycoplasma and Chlamydia. Severe pneumonia is most often associated with a wide range of organisms. Some are very virulent (potent) but are extremely curable, while others are difficult to treat. Mycoplasma and Chlamydia are the most common causes of mild pneumonias and are most likely to occur in children and young adults. They rarely require hospitalisation when they are appropriately treated, although recovery may still be prolonged. Severe and life-threatening cases are more likely to occur in elderly people with other medical conditions. Researchers from the Hospital Universitari de Bellvitge in Barcelona studied 308 patients who were hospitalised with severe pneumonia. Out of this, 238 patients, i.e. 77 per cent, were treated with antibiotics alone and 70 patients, i.e. 23 per cent, were treated with antibiotics plus steroid therapy. Steroid use was associated with a significant 72 per cent reduction in deaths at 30 days. Prior research has shown elevated levels of both local and circulating inflammatory proteins in patients with community-acquired pneumonia. Thus, it has been theorised that treatment with systemic steroids may have a beneficial effect in attenuating inflammation and improving patient outcomes. However, it is still unclear whether this actually occurs, particularly in patients already receiving standard antibiotic therapy.