Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial

  • Blum C
  • Nigro N
  • Briel M
 et al. 
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Background Clinical trials yielded conflicting data about the benefit of adding systemic corticosteroids for treatment of community-acquired pneumonia. We assessed whether short-term corticosteroid treatment reduces time to clinical stability in patients admitted to hospital for community-acquired pneumonia. Methods In this double-blind, multicentre, randomised, placebo-controlled trial, we recruited patients aged 18 years or older with community-acquired pneumonia from seven tertiary care hospitals in Switzerland within 24 h of presentation. Patients were randomly assigned (1:1 ratio) to receive either prednisone 50 mg daily for 7 days or placebo. The computer-generated randomisation was done with variable block sizes of four to six and stratified by study centre. The primary endpoint was time to clinical stability defined as time (days) until stable vital signs for at least 24 h, and analysed by intention to treat. This trial is registered with, number NCT00973154. Findings From Dec 1, 2009, to May 21, 2014, of 2911 patients assessed for eligibility, 785 patients were randomly assigned to either the prednisone group (n=392) or the placebo group (n=393). Median time to clinical stability was shorter in the prednisone group (3.0 days, IQR 2.5-3.4) than in the placebo group (4.4 days, 4.0-5.0; hazard ratio [HR] 1.33, 95% CI 1.15-1.50, p

Author-supplied keywords

  • Swiss
  • Switzerland
  • adult
  • adult respiratory distress syndrome/co [Complicati
  • aged
  • article
  • cerebrovascular accident/si [Side Effect]
  • chronic kidney failure
  • chronic obstructive lung disease
  • clinical trial (topic)
  • community acquired pneumonia
  • community acquired pneumonia/dt [Drug Therapy]
  • computer
  • controlled study
  • corticosteroid
  • corticosteroid therapy
  • delirium/si [Side Effect]
  • diabetes mellitus
  • double blind procedure
  • female
  • fracture/si [Side Effect]
  • funding
  • gastrointestinal hemorrhage/si [Side Effect]
  • hazard ratio
  • heart failure
  • hospital
  • hospital cost
  • hospital infection/si [Side Effect]
  • human
  • hyperglycemia
  • hyperglycemia/si [Side Effect]
  • hypertension/si [Side Effect]
  • incidence
  • insulin dependence/si [Side Effect]
  • insulin treatment
  • intention to treat analysis
  • length of stay
  • major clinical study
  • male
  • multicenter study
  • non profit organization
  • patient
  • placebo
  • pneumonia
  • pneumonia/co [Complication]
  • prednisone
  • prednisone/ae [Adverse Drug Reaction]
  • prednisone/ct [Clinical Trial]
  • prednisone/dt [Drug Therapy]
  • priority journal
  • randomization
  • randomized controlled trial
  • respiratory failure/co [Complication]
  • risk
  • silver
  • tertiary care center
  • therapy
  • thromboembolism/si [Side Effect]
  • treatment outcome
  • treatment response
  • vital sign

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  • Ca Blum

  • N Nigro

  • M Briel

  • P Schuetz

  • E Ullmer

  • I Suter-Widmer

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