TUESDAY, May 31 (HealthDay News) -- Patients with an
inflammatory lung condition known as community-acquired pneumonia
appear to recover faster when treated with corticosteroids in
addition to the standard regimen of antibiotics, Dutch researchers
say.
Those treated with a combination of corticosteroids and
antibiotics also required a shorter hospital stay than patients
treated with antibiotics alone, the study authors found.
The observations stem from what is believed to be the largest
study to date focused on the potential of corticosteroids for the
treatment of community-acquired pneumonia, or CAP.
Dr. Sabine Meijvis, from the St. Antonius Hospital in
Nieuwegein, the Netherlands, and colleagues reported their findings
in the May 31 online edition of
The Lancet.
Meijvis and her team noted that, currently, CAP is typically
treated with antibiotics following an early diagnosis.
To explore whether corticosteroids might reduce the risk for
complications and fatalities, the team focused on just over 300
Dutch CAP patients. Half of the patients were placed on a standard
antibiotic protocol coupled with 5 milligrams a day of the
corticosteroid dexamethasone. The other half were given antibiotics
plus a placebo (an inactive treatment).
After four days, the research team found that those given the
corticosteroid experienced less lung inflammation, and recovered
more quickly than those who were just given antibiotics.
The corticosteroid group also required one less day of
hospitalization than the antibiotic group (6.5 days versus 7.5
days). In addition, by the end of one month, the corticosteroid
group had experienced better "social functioning" relative to the
antibiotic group, the investigators found.
"Serious adverse events were rare" among the corticosteroid group, the study team noted in a journal news release, while at the same time cautioning that "the benefits of corticosteroids should be weighed against the potential disadvantages of these drugs, such as superinfections and gastric disturbances."
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital
in New York City, said the findings were in line with what he might
expect.
"It doesn't surprise me because corticosteroids are used as nuclear anti-inflammatories," he said, noting they might suppress an otherwise lingering fever within 24 hours. "And they would mask a lot of symptoms and make a patient feel generally better whether they're asthmatics or have some inflammatory disease."
"But the downside," he cautioned, "is that we know that corticosteroids are immune-suppressive. And so the possibility exists that when you use them, you could be prolonging the actual recovery time even as you are masking the symptoms, although this study doesn't say that."
This is a potential danger for otherwise healthy people and
especially so for those who have high blood pressure or diabetes,
he said. "So any medication is a double-edged sword," he added.
"And the use of corticosteroids in this case has to be weighed
against possible complications."
More information
For more on pneumonia, visit the
U.S. National Library of Medicine.