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M. S. Niederman, L. A. Mandell, A. Anzueto, J. B. Bass, W. A. Broughton, G. D. Campbell, N. Dean, T. File, M. J. Fine, P. A. Gross, F. Martinez, T. J. Marrie, J. F. Plouffe, J. Ramirez, G. A. Sarosi, A. Torres, R. Wilson and V. L. Yu, “Guide Lines for the Management of Adults with Community-Acquired Pneumonia. Diagnosis, Assessment of Severity, Antimicrobial Therapy, and Prevention,” American Journal of Respiratory and Critical Care Medicine, Vol. 163, No. 7, 2001, pp. 1730-1754.

has been cited by the following article:

• TITLE: Corticosteroids and ICU Course of Community Acquired Pneumonia in Egyptian Settings

  AUTHORS: Nirmeen A. Sabry, Emad El-Din Omar

  KEYWORDS: Community-Acquired Pneumonia, Corticosteroids, Hydrocortisone, Pneumonia

  JOURNAL NAME: Pharmacology & Pharmacy, Vol.2 No.2, March 30, 2011

  ABSTRACT: Background: Pneumonia is the most common cause of community-acquired infection requiring ICU admission. 60-87% of patients with severe community acquired pneumonia (CAP) admitted to the ICU develops respiratory failure and require mechanical ventilation (MV). Objectives: To assess the efficacy and safety of adjunctive low dose hydrocortisone infusion treatment in Egyptian ICU patients with CAP. Methods: Hospitalized patients, clinically and radiologically diagnosed with CAP, were randomized to receive hydrocortisone 12.5 mg/h IV infusion for 7 days or placebo, along with antibiotics. The end-points of the study were improvement in PaO2:FIO2 (PaO2:FIO2 > 300 or ≥100 increase from study entry) and SOFA score by study day 8 and the development of delayed septic shock. Results: 80 patients were recruited, 40 of them received hydrocortisone and the remaining 40 received placebo. By study day 8, hydrocortisone treated patients showed a significant improvement in PaO2:FIO2 and chest radiograph score, and a significant reduction in C-reactive protein (CRP) levels, Sepsis-related Organ Failure Assessment (SOFA) score, and delayed septic shock compared to the control group. Hydrocortisone treatment was associated with a significant reduction in the duration of MV. However, hydrocortisone infusion did not show significant difference in the ICU mortality. Conclusions: adjunctive 7-day course of low dose hydrocortisone IV in patients with CAP hastens recovery of pneumonia and prevents the development of sepsis related complications with a significant reduction in duration of the mechanical ventilation.