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Corticosteroid for community acquired pneumonia

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https://www.readbyqxmd.com/read/29690685/-current-status-of-diagnosis-and-treatment-of-community-acquired-pneumonia-in-shanghai-revealed-by-a-questionnaire-analysis
#1
J Liu, J Zhang, Q J Cheng, J F Xu, Z J Jie, Y Jiao, Y Huang, J M Qu
Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29661670/-community-acquired-pneumonia-in-patients-with-chronic-obstructive-pulmonary-disease-treated-with-inhaled-corticosteroids-or-other-bronchodilators-study-pneumocort
#2
Rosa Morros, Cristina Vedia, Maria Giner-Soriano, Aina Casellas, Ester Amado, Jose Miguel Baena
OBJECTIVES: To analyse the risk of pneumonia and/or exacerbations in patients with chronic obstructive pulmonary disease (COPD) who receive treatment with inhaled corticosteroids (CI), in comparison with those who are not treated with inhaled corticosteroids (NCI). To estimate the risk of pneumonia according to CI dose. DESIGN: Population-based cohort study. SETTING: Primary Healthcare. Institut Català de la Salut. PARTICIPANTS: Patients ≥45 years-old diagnosed with COPD between 2007 and 2009 in the Information System for Research in Primary Care (SIDIAP)...
April 13, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29562397/-clinical-characteristics-and-prognosis-of-long-term-glucocorticoid-users-with-community-acquired-pneumonia
#3
L J Li, Y M Liu, Y M Wang, F Zhou, H Li, X Q Xing, X D Han, L Chen, C X Zhang, J X Wang, B Liu, L J Suo, G H Yu, G Q Wang, X X Yao, Y Xiao, X L Zhu, C X Xue, X J Cui, B Cao
Objective: To explore the clinical features, etiological features and prognostic risk factors of long-term glucocorticoid users with community-acquired pneumonia (CAP). Methods: A retrospective study included 100 long-term glucocorticoid users with CAP (G-CAP group) from 11 hospitals of China between January 2014 and December 2014, while 100 non-immunocompromised patients with community-acquired pneumonia were enrolled as controls (nICH-CAP group). Characteristics including age, gender, underlying diseases, corticosteroids, symptoms, disease severity, imaging manifestations, etiology, respiratory failure, mechanical ventilation, whether the application of vasoactive drugs, antibiotics application, hospital mortality rate between the two groups were compared, and the prognostic factors of G-CAP were investigated using Logistic regression...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29553440/inpatient-management-of-community-acquired-pneumonia-at-the-european-gaza-hospital-a-clinical-audit
#4
Said Alyacoubi, Yousef Abuowda, Loai Albarqouni, Bettina Böttcher, Khamis Elessi
BACKGROUND: Disease severity scores such as CURB-65 are often used to guide the management of patients with community-acquired pneumonia. Early and adequate empirical antibiotic treatment reduces mortality. The aim of this study was to examine the severity assessment and management of patients presenting with community-acquired pneumonia at the European Gaza Hospital in the Gaza Strip and to compare this to the best available evidence. METHODS: Medical records of all patients admitted to the European Gaza Hospital with a diagnosis of community-acquired pneumonia between Dec 1, 2015, and March 31, 2016, were reviewed retrospectively...
February 21, 2018: Lancet
https://www.readbyqxmd.com/read/29548654/recent-trends-in-practice-patterns-and-impact-of-corticosteroid-use-on-pediatric-mycoplasma-pneumoniae-related-respiratory-infections
#5
Yusuke Okubo, Nobuaki Michihata, Naho Morisaki, Kazuhiro Uda, Isao Miyairi, Yuichi Ogawa, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Mycoplasma pneumoniae is a major pathogen causing community-acquired pneumonia/bronchitis in children, and macrolide-resistant strains are increasing in East Asian countries. Recent practice patterns, especially for antibiotic selection, and benefits of corticosteroid treatment in pediatric Mycoplasma pneumoniae infections remain unclear. METHODS: Using the Japanese Diagnosis Procedure Combination inpatient database, we analyzed recent trends in antibiotic selection and corticosteroid use for pediatric Mycoplasma pneumoniae-related respiratory infections, using multivariable mixed effects logistic regressions...
March 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29545274/acute-respiratory-distress-syndrome-in-mechanically-ventilated-patients-with-community-acquired-pneumonia
#6
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition.We prospectively enrolled consecutive mechanically ventilated adult ICU patients with CAP over 20 years, and compared them with mechanically ventilated patients without ARDS. The main outcome was 30-day mortality.Among 5334 patients hospitalised with CAP, 930 (17%) were admitted to the ICU and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29402313/the-improve-gap-trial-aiming-to-improve-evidence-based-management-of-community-acquired-pneumonia-study-protocol-for-a-stepped-wedge-randomised-controlled-trial
#7
Elizabeth H Skinner, Melanie Lloyd, Edward Janus, May Lea Ong, Amalia Karahalios, Terry P Haines, Anne-Maree Kelly, Melina Shackell, Harin Karunajeewa
BACKGROUND: Community-acquired pneumonia is a leading worldwide cause of hospital admissions and healthcare resource consumption. The largest proportion of hospitalisations now occurs in older patients, with high rates of multimorbidity and complex care needs. In Australia, this population is usually managed by hospital inpatient general internal medicine units. Adherence to consensus best-practice guidelines is poor. Ensuring evidence-based care and reducing length of stay may improve patient outcomes and reduce organisational costs...
February 5, 2018: Trials
https://www.readbyqxmd.com/read/29380739/management-of-community-acquired-pneumonia-in-adults-2016-guideline-update-from-the-dutch-working-party-on-antibiotic-policy-swab-and-dutch-association-of-chest-physicians-nvalt
#8
W J Wiersinga, M J Bonten, W G Boersma, R E Jonkers, R M Aleva, B J Kullberg, J A Schouten, J E Degener, E M W van de Garde, T J Verheij, A P E Sachs, J M Prins
The Dutch Working Party on Antibiotic Policy in collaboration with the Dutch Association of Chest Physicians, the Dutch Society for Intensive Care and the Dutch College of General Practitioners have updated their evidence-based guidelines on the diagnosis and treatment of community-acquired pneumonia (CAP) in adults who present to the hospital. This 2016 update focuses on new data on the aetiological and radiological diagnosis of CAP, severity classification methods, initial antibiotic treatment in patients with severe CAP and the role of adjunctive corticosteroids...
January 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29236286/corticosteroids-for-pneumonia
#9
REVIEW
Anat Stern, Keren Skalsky, Tomer Avni, Elena Carrara, Leonard Leibovici, Mical Paul
BACKGROUND: Pneumonia is a common and potentially serious illness. Corticosteroids have been suggested for the treatment of different types of infection, however their role in the treatment of pneumonia remains unclear. This is an update of a review published in 2011. OBJECTIVES: To assess the efficacy and safety of corticosteroids in the treatment of pneumonia. SEARCH METHODS: We searched the Cochrane Acute Respiratory Infections Group's Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS on 3 March 2017, together with relevant conference proceedings and references of identified trials...
December 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29020323/corticosteroids-in-patients-hospitalized-with-community-acquired-pneumonia-systematic-review-and-individual-patient-data-metaanalysis
#10
Matthias Briel, Simone M C Spoorenberg, Dominic Snijders, Antoni Torres, Silvia Fernandez-Serrano, G Umberto Meduri, Albert Gabarrús, Claudine A Blum, Marco Confalonieri, Benjamin Kasenda, Reed A C Siemieniuk, Wim Boersma, Willem Jan W Bos, Mirjam Christ-Crain
Background: Our aim was to evaluate the benefits and harms of adjunctive corticosteroids in adults hospitalized with community-acquired pneumonia (CAP) using individual patient data from randomized, placebo-controlled trials and to explore subgroup differences. Methods: We systematically searched Medline, Embase, Cochrane Central, and trial registers (all through July 2017). Data from 1506 individual patients in 6 trials were analyzed using uniform outcome definitions...
January 18, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28756034/efficacy-of-corticosteroid-treatment-for-severe-community-acquired-pneumonia-a-meta-analysis
#11
Wei-Fang Wu, Qiang Fang, Guo-Jun He
BACKGROUND: The benefits and adverse effects of corticosteroids in the treatment of severe community-acquired pneumonia (CAP) have not been well assessed. The aim of this systematic review of the literature and meta-analysis was to evaluate the clinical efficacy of adjuvant corticosteroid therapy in patients with severe CAP. METHODS: The following databases were searched: PubMed, the Cochrane database, Embase, Wanfang, the China National Knowledge Infrastructure (CNKI), and the WeiPu (VIP) database in Chinese...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28694698/maintenance-therapy-in-copd-time-to-phase-out-ics-and-switch-to-the-new-lama-laba-inhalers
#12
REVIEW
Syed Mohammad Tariq, Enson C Thomas
Long-term maintenance therapy for COPD is evolving rapidly. Dual bronchodilation with new long-acting muscarinic antagonist and long-acting beta-agonist (LAMA/LABA) fixed dose combination inhalers were introduced over the past 2 years. In clinical trials, these inhalers significantly improved lung function (trough forced expiratory volume in 1 second), patient-reported outcomes, and quality of life measures compared with placebo, their respective monocomponents, and tiotropium. The recorded adverse events of these new inhalers were also similar to those of their monocomponents or placebo...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#13
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28690980/crh-affects-the-phenotypic-expression-of-sepsis-associated-virulence-factors-by-streptococcus-pneumoniae-serotype-1-in-vitro
#14
Colette G Ngo Ndjom, Lindsay V Kantor, Harlan P Jones
Sepsis is a life-threatening health condition caused by infectious pathogens of the respiratory tract, and accounts for 28-50% of annual deaths in the US alone. Current treatment regimen advocates the use of corticosteroids as adjunct treatment with antibiotics, for their broad inhibitory effect on the activity and production of pro-inflammatory mediators. However, despite their use, corticosteroids have not proven to be able to reverse the death incidence among septic patients. We have previously demonstrated the potential for neuroendocrine factors to directly influence Streptococcus pneumoniae virulence, which may in turn mediate disease outcome leading to sepsis and septic shock...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28690643/mechanism-of-resistance-acquisition-and-treatment-of-macrolide-resistant-mycoplasma-pneumoniae-pneumonia-in-children
#15
REVIEW
Hyeon-Jong Yang, Dae Jin Song, Jung Yeon Shim
Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006-2007, 2011, and 2015-2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%-90%...
June 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28634021/mycoplasma-pneumoniae-and-health-outcomes-in-children-with-asthma
#16
Pamela R Wood, Jordan C Kampschmidt, Peter H Dube, Marianna P Cagle, Paola Chaparro, Norma S Ketchum, Thirumalai R Kannan, Harjinder Singh, Jay I Peters, Joel B Baseman, Edward G Brooks
BACKGROUND: Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control. OBJECTIVE: To determine the effect of Mp on asthma control. METHODS: We enrolled 31 pediatric subjects 3 to 10 years of age with persistent asthma who completed up to 8 visits over a 24-month period...
August 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28403766/controversies-in-diagnosis-and-management-of-community-acquired-pneumonia
#18
REVIEW
Sarah Sparham, Patrick Gp Charles
Community-acquired pneumonia (CAP) is a common condition; however, it appears to be overdiagnosed. Diagnosing CAP too frequently may be adding to the problems of overuse of antibiotics, such as bacterial resistance in the community and greater costs and complications in individuals. Data support that most patients with non-severe CAP can be treated for 3-5 days; however, most patients with CAP are receiving much longer courses of therapy. Macrolides such as azithromycin have the potential to prolong the QT interval, although large population studies show that this does not appear to result in excess cardiac mortality...
April 17, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28335807/time-dependent-association-of-glucocorticoids-with-adverse-outcome-in-community-acquired-pneumonia-a-6-year-prospective-cohort-study
#19
Manuela Nickler, Manuel Ottiger, Christian Steuer, Alexander Kutz, Mirjam Christ-Crain, Werner Zimmerli, Robert Thomann, Claus Hoess, Christoph Henzen, Luca Bernasconi, Andreas Huber, Beat Mueller, Philipp Schuetz
BACKGROUND: The hypothalamic-pituitary-adrenal stress axis plays a crucial role in community-acquired pneumonia (CAP), with high cortisol being associated with disease severity and corticosteroid treatment resulting in earlier time to recovery. Our aim in the present study was to compare different glucocorticoid hormones, including cortisol, 11-deoxycortisol, cortisone, and corticosterone, regarding their association with short- and long-term adverse outcomes in a well-defined CAP cohort...
March 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28302543/immunomodulatory-effects-of-pidotimod-in-adults-with-community-acquired-pneumonia-undergoing-standard-antibiotic-therapy
#20
D Trabattoni, M Clerici, S Centanni, M Mantero, M Garziano, F Blasi
The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0-2 were randomized to receive either levofloxacin 500 mg b...
June 2017: Pulmonary Pharmacology & Therapeutics
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