Pneumonie

CONCLUSIONS:The best evidence supports CRP as the preferred biomarker for diagnosis of outpatient CAP given its accuracy, low cost, and point-of-care availability.

Corticostéroïdes

Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial. Lloyd M, Karahalios A, Janus E, Skinner EH, Haines T, De Silva A, Lowe S, Shackell M, Ko S, Desmond L, Karunajeewa H; Improving Evidence-Based Treatment Gaps and Outcomes in Community-Acquired Pneumonia (IMPROVE-GAP) Implementation Team at Western Health. JAMA Intern Med. 2019 Jul 8. doi: 10.1001/jamainternmed.2019.1438. [Epub ahead of print]

Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Seagraves T, Gottlieb M. Ann Emerg Med. 2019 Jul;74(1):e1-e3. doi: 10.1016/j.annemergmed.2018.05.001. Epub 2018 Jun 22. No abstract available. PMID: 29937237

Efficacy of corticosteroid treatment for severe community-acquired pneumonia: A meta-analysis. Wu WF, Fang Q, He GJ, Am J Emerg Med. 2018 Feb;36(2):179-184. doi: 10.1016/j.ajem.2017.07.050. Epub 2017 Jul 15. PubMed PMID: 28756034.

Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Seagraves, Thomas et al. Annals of Emergency Medicine, Published online, June 21, 2018, DOI: https://doi.org/10.1016/j.annemergmed.2018.05.001

Take-Home Message: For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality.

The average duration of treatment was 7 days. Most adult studies used a corticosteroid dose equivalent to 40 to 50 mg of prednisone per day.