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World J Emerg Med. 2015;6(3):172-8. doi: 10.5847/wjem.j.1920-8642.2015.03.002.

Efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia: A meta-analysis of randomized controlled trials.

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Department of Respiratory and Critical Care Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China.
Department of Pharmacy, Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, China.



Community-acquired pneumonia (CAP) is pneumonia acquired infectiously from normal social contact as opposed to being acquired during hospitalization. CAP is a leading cause of illness and death. This review aims to determine the efficacy and safety of glucocorticoids in the treatment of community-acquired pneumonia (CAP).


We searched randomized controlled trials (RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, and Chinese Biomedical Literature Database to obtain the information by using steroids, glucocorticoids, cortisol, corticosteroids, community-acquired pneumonia and CAP as key words. The quality of RCTs was evaluated. A Meta-analysis was made using RevMan 5.0 provided by the Cochrance Collaboration.


Seven RCTs involving 944 patients were included in the meta-analysis. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in standard treatment group (WMD=-1.70, 95%CI 2.01-1.39, Z=10.81, P<0.00001). No statistically significant differences were found in the mortality rate (RR=0.77,95%CI 0.46-1.27, Z=1.03, P=0.30), the mean length of hospital stay in ICU (WMD=1.17, 95%CI 1.68-4.02, Z=0.81, P=0.42), the incidence of super infection (RR=1.32, 95%CI 0.66-2.63, Z=0.79, P=0.43), the incidence of hyperglycemia (RR=1.84, 95%CI 0.76-4.41, Z=1.36, P=0.17), the incidence of upper gastrointestinal bleeding (RR=1.98, 95%CI 0.37-10.59, Z=0.80, P=0.42) between the standard treatment group and the glucocorticoids treatment group.


The use of glucocorticoids in patients with community-acquired pneumonia can significantly shorten the duration of illness and have a favorable safety profile. However, it could not reduce the overall mortality.


Community-acquired pneumonia; Glucocorticoids; Meta-analysis

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