Corticosteroids in the adjunctive therapy of community-acquired pneumonia : an appraisal of recent meta-analyses of clinical trials

Show simple item record Feldman, Charles Anderson, Ronald 2016-06-08T05:11:44Z 2016-06-08T05:11:44Z 2016-03
dc.description This is an invited article commissioned by the Section Editor Wan-Jie Gu (Department of Anesthesiology, Affiliated Drum Tower Hospital, Medical College of Nanjing University, Nanjing, China). en_ZA
dc.description.abstract Improving the outcome of patients with community-acquired pneumonia (CAP) is an ongoing challenge, even in the setting of significant advances in antimicrobial chemotherapy and critical care. Recognition of the underlying involvement of inflammation-mediated organ dysfunction as a determinant of adverse outcomes in CAP has aroused intense interest in the protective potential of adjunctive antiinflammatory therapies in CAP, particularly the role of corticosteroids (CS). This is the primary topic of the current review which is focused on an evaluation of the latest meta-analyses encompassing both recent and earlier clinical trials, with particular emphasis on the stringent meta-analysis undertaken by Siemieniuk and colleagues (Ann Intern Med 2015;163:519–528). The review highlights the findings and recommendations of these and related published commentaries/critiques, while providing a brief description of those subgroups of patients who seemingly stand to benefit most from CS therapy. This is preceded by an overview of the mechanisms of the anti-inflammatory activities of CS, the interactions of these agents with macrolide antibiotics, and the potential benefits and risks of short-term administration of CS, concluding with a succinct appraisal of priority issues for ongoing and future research. en_ZA
dc.description.department Immunology en_ZA
dc.description.librarian am2016 en_ZA
dc.description.sponsorship C Feldman is supported by the National Research Foundation of South Africa. en_ZA
dc.description.uri en_ZA
dc.identifier.citation Feldman C, Anderson R. Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials. J Thorac Dis 2016;8(3):E162-E171. DOI: 10.21037/jtd.2016.02.43. en_ZA
dc.identifier.issn 2072-1439 (print)
dc.identifier.issn 2077-6624 (online)
dc.identifier.other 10.21037/jtd.2016.02.43
dc.language.iso en en_ZA
dc.publisher AME Publishing Company en_ZA
dc.rights © Journal of Thoracic Disease. All rights reserved. en_ZA
dc.subject Anti-inflammatory en_ZA
dc.subject Corticosteroids (CS) en_ZA
dc.subject C-Reactive protein (CRP) en_ZA
dc.subject Inflammation en_ZA
dc.subject Macrolides en_ZA
dc.subject Meta-analysis en_ZA
dc.subject Methylprednisolone en_ZA
dc.subject Neutrophils en_ZA
dc.subject Community-acquired pneumonia (CAP) en_ZA
dc.title Corticosteroids in the adjunctive therapy of community-acquired pneumonia : an appraisal of recent meta-analyses of clinical trials en_ZA
dc.type Article en_ZA

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