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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, January 26, 2021

Steroids for CAP

First10EM - By Justin Morgenstern - January 26, 2021
"Outside of asthma or COPD, I have never prescribed steroids for community acquired pneumonia. Almost everyone has heard that dexamethasone might decrease mortality in COVID, but it is possible we should be using steroids in CAP as well. Although I have heard rumors of benefit for years, I have never seen steroids prescribed for pneumonia, so this literature deep dive has always sat on the back-burner. Today I will finally try to answer the question of whether we should be prescribing steroids for all our pneumonia patients. (If you don’t want to read the whole article, the answer is no.)...
Overall, the available evidence is incredibly weak. Although the Cochrane review suggests a mortality benefit, after reading the studies that comprise that review, I have very little faith in the conclusion. I do not think there is any strong reason to be using steroids for community acquired pneumonia at this time. There also isn’t strong evidence against steroids. However, steroids have well documented harms, so without good evidence, they should probably be avoided."