Featured Research

from universities, journals, and other organizations

Prednisolone not benficial in most cases of community-acquired pneumonia, study finds

Date:
February 23, 2010
Source:
American Thoracic Society
Summary:
Patients hospitalized with mild to moderate community-acquired pneumonia should not be routinely prescribed prednisolone, a corticosteroid, as it is associated with a recurrence of symptoms after its withdrawal, according to the first randomized double-blind clinical trial to address the subject.

Patients hospitalized with mild to moderate community-acquired pneumonia (CAP) should not be routinely prescribed prednisolone, a corticosteroid, as it is associated with a recurrence of symptoms after its withdrawal, according to the first randomized double-blind clinical trial to address the subject.

"Prednisolone therapy next to antibiotic therapy in patients hospitalized with CAP should not be recommend due to lack of clincial benefit and a higher rate of late failures," said Dominic Snijders, M.D., lead author on the study and at the Medical Centre Alkmaar in the Netherlands.

The findings have been published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

To assess the efficacy of prednisolone therapy along with standard doctor-managed care for patients admitted to the hospital with CAP, Dr. Snijders and colleagues prospectively enrolled 213 patients who had been hospitalized with CAP and randomly assigned them to receive the usual antibiotic therapy as prescribed by their physicians supplemented with either prednisolone (40 mg dose once daily) or placebo for a week.

They found that patients on prednisolone recovered more rapidly from their fevers and had a more rapid decline in their c-reactive protein (CRP) levels than patients on placebo, indicating decreased inflammation. However, after 14 days, the patients in the prednisolone group had higher levels of CRP than the patients in the placebo group. Furthermore, three times as many patients in the prednisolone group had "late failure," defined as the recurrence of symptoms more than 72 hours after initial therapeutic success, and these patients were almost four times as likely to require additional antibiotic treatment than patients with late failure in the placebo group (6.7 percent versus 1.8 percent).

"Our study clearly shows that prednisolone therapy does not have a place in patients with CAP," said Dr. Snijders. However, he pointed out, in some cases such as when CAP is severe or occurs in conjunction with COPD, there is not enough information to draw a conclusion. Previous studies have found benefit of corticosteroid therapy among patients with severe CAP. Studies with patients with CAP and COPD have also indicated the possibility of a protective effect of prednisolone, but there have been no controlled trials.

Dr. Snijders suggested that the association of prednisolone therapy in CAP with late failures may be due to a rebound effect that could be precipitated by the abrupt withdrawal of the therapy. "Non-survivors on corticosteroid therapy died later than non-survivors without corticosteroids, respectively 13.8 versus 7.1 days," he wrote. "A tapering of the corticosteroids might protect against the rebound of inflammation."

"Further trials are indeed needed in patients with severe CAP," said Dr. Snijders. "Also, more information is needed about COPD patients, corticosteroids and pneumonia. Possible future intervention could be monoclonal TNF-alpha-antibodies or specific antibodies against other key mediators in the inflammation response. We are considering further studies in these directions."


Story Source:

The above story is based on materials provided by American Thoracic Society. Note: Materials may be edited for content and length.


Cite This Page:

American Thoracic Society. "Prednisolone not benficial in most cases of community-acquired pneumonia, study finds." ScienceDaily. ScienceDaily, 23 February 2010. <www.sciencedaily.com/releases/2010/02/100223101434.htm>.
American Thoracic Society. (2010, February 23). Prednisolone not benficial in most cases of community-acquired pneumonia, study finds. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2010/02/100223101434.htm
American Thoracic Society. "Prednisolone not benficial in most cases of community-acquired pneumonia, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/02/100223101434.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Possible Ebola Patient in Isolation at California Hospital

Possible Ebola Patient in Isolation at California Hospital

Reuters - US Online Video (Aug. 20, 2014) — A patient who may have been exposed to the Ebola virus is in isolation at the Kaiser Permanente South Sacramento Medical Center. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Raw: World's Oldest Man Lives in Japan

Raw: World's Oldest Man Lives in Japan

AP (Aug. 20, 2014) — A 111-year-old Japanese was certified as the world's oldest man by Guinness World Records on Wednesday. Sakari Momoi, a native of Fukushima in northern Japan, was given a certificate at a hospital in Tokyo. (Aug. 20) Video provided by AP
Powered by NewsLook.com
Do More Wedding Guests Make A Happier Marriage?

Do More Wedding Guests Make A Happier Marriage?

Newsy (Aug. 20, 2014) — A new study found couples who had at least 150 guests at their weddings were more likely to report being happy in their marriages. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Freetown a City on Edge

Ebola-Hit Sierra Leone's Freetown a City on Edge

AFP (Aug. 19, 2014) — Residents of Sierra Leone's capital voice their fears as the Ebola virus sweeps through west Africa. Duration: 00:56 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins