Table 1

Recent literature on the role of corticosteroids in severe community-acquired pneumonia

Reference
Study design
Sample size, number
Patient selection
Corticosteroids (drug/regimen)
Primary endpoints
Level of evidence and recommendation

Marik, et al. [21]
Single-center RCT
30
Severe CAP
Hydrocortisone 10 mg/kg versus placebo 30 minutes before antibiotics
Mortality, clinical course, and serum TNF-α levels
Weak recommendation, moderate-quality evidence
Confalonieri, et al. [6]
Multicenter RCT
46
Severe CAP
Hydrocortisone 200 mg + hydrocortisone 10 mg/hour, for 7 days versus placebo
Mortality, clinical course, and Systemic inflammation
Strong recommendation, moderate-quality evidence
Mikami, et al. [20]
Open label RCT
31
Moderate and severe CAP
Prednisolone 40 mg qd, for 3 days versus placebo
Mortality and clinical course
Weak recommendation, low-quality evidence
Garcia-Vidal, et al. [19]
Retrospective cohort study
308
Severe CAP
Methylprednisolone 45 mg (or equivalent) qd for 11.4 days
Mortality
Strong recommendation, low-quality evidence

CAP, community-acquired pneumonia; qd, quaque die (every day); RCT, randomized controlled trial; TNF-α, tumor necrosis factor-alpha.

Salluh et al. Critical Care 2008 12:434   doi:10.1186/cc7107