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Prednisolone not benficial in most cases of community-acquired pneumonia
Date:2/23/2010

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
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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