Systemic and Inhaled Corticosteroids, with or without Beta Agonists, as Adjuvant Therapy in Community Acquired Pneumonia

Authors

  • Scott A. Helgeson Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL
  • Joseph E. Levitt Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA
  • Emir Festic Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA

DOI:

https://doi.org/10.5644/ama2006-124.279

Keywords:

Pneumonia, Corticosteroids, Beta-Agonists

Abstract

The aim is to provide a narrative review of the role of corticosteroids, with and without inhaled beta agonist, in communityacquired pneumonia. Community and health-care associated pneumonia remain leading causes of morbidity and mortality despite appropriate antibiotic therapy. The pneumonia-associated adverse outcomes are not only related to the infectious organism, but also to a dysfunctional host-immune response resulting in overwhelming inflammation. Use of systemic corticosteroids as adjuvant therapy in pneumonia remains controversial. Multiple randomized clinical trials evaluating corticosteroids in patients with community acquired pneumonia have found discrepant results in terms of benefits and adverse effects. Inhaled delivery of corticosteroids offer the potential advantage of providing therapeutic benefits directly to the lung, with minimal to no adverse systemic effects.

Conclusion. Although meta-analyses suggest potential benefits in a select group of patients with more severe pneumonia, the ideal timing, dose, route of delivery, duration, and patient selection remain to be established. A smaller body of literature suggests benefit of inhaled corticosteroids, with or without inhaled beta agonists, but future large scale clinical trials are needed to establish clinical benefit with inhaled delivery.

Downloads

Download data is not yet available.

Downloads

Published

2020-08-01

How to Cite

Helgeson, S. A., Levitt, J. E., & Festic, E. (2020). Systemic and Inhaled Corticosteroids, with or without Beta Agonists, as Adjuvant Therapy in Community Acquired Pneumonia. Acta Medica Academica, 49(1), 9–20. https://doi.org/10.5644/ama2006-124.279

Issue

Section

Clinical Science

Most read articles by the same author(s)