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

dc.contributor.authorFeldman, Charles
dc.contributor.authorAnderson, Ronald
dc.date.accessioned2016-06-08T05:11:44Z
dc.date.available2016-06-08T05:11:44Z
dc.date.issued2016-03
dc.descriptionThis 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.abstractImproving 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.departmentImmunologyen_ZA
dc.description.librarianam2016en_ZA
dc.description.sponsorshipC Feldman is supported by the National Research Foundation of South Africa.en_ZA
dc.description.urihttp://jtd.amegroups.comen_ZA
dc.identifier.citationFeldman 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.issn2072-1439 (print)
dc.identifier.issn2077-6624 (online)
dc.identifier.other10.21037/jtd.2016.02.43
dc.identifier.urihttp://hdl.handle.net/2263/52899
dc.language.isoenen_ZA
dc.publisherAME Publishing Companyen_ZA
dc.rights© Journal of Thoracic Disease. All rights reserved.en_ZA
dc.subjectAnti-inflammatoryen_ZA
dc.subjectCorticosteroids (CS)en_ZA
dc.subjectC-Reactive protein (CRP)en_ZA
dc.subjectInflammationen_ZA
dc.subjectMacrolidesen_ZA
dc.subjectMeta-analysisen_ZA
dc.subjectMethylprednisoloneen_ZA
dc.subjectNeutrophilsen_ZA
dc.subjectCommunity-acquired pneumonia (CAP)en_ZA
dc.titleCorticosteroids in the adjunctive therapy of community-acquired pneumonia : an appraisal of recent meta-analyses of clinical trialsen_ZA
dc.typeArticleen_ZA

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