Evidence map›Paper›PMID 25608756›Full record

Trial reportLancet (London, England)2015

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

Claudine Angela Blum, Nicole Nigro, Matthias Briel, Philipp Schuetz, Elke Ullmer, Isabelle Suter-Widmer, Bettina Winzeler, Roland Bingisser, Hanno Elsaesser, Daniel Drozdov and 13 more

3 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 179 papers, 23 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
179citing papers in PubMed, 23 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00973154 phase3completednot on this map

Corticosteroid Treatment for Community-Acquired Pneumonia A Randomized, Double-blind Study- The STEP Trial

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2009 to 2014Enrolled800ConditionsCommunity-acquired PneumoniaArmsPrednisone
NCT02835040 nacompletednot on this mapstarted 2016, after this paper: background citation

Evaluating the Impact of a New Model of Care Designed to Improve Evidence-based Management of Community-acquired Pneumonia

TypeinterventionalSponsorWestern Health, AustraliaRan2016 to 2017Enrolled814ConditionsPneumoniaArmsNew model of service delivery, Current practice
NCT05354778 nacompletednot on this mapstarted 2022, after this paper: background citation

HYDROcortisone Versus Placebo for Severe HospItal-acquired Pneumonia in Intensive Care Patients: the HYDRO-SHIP Study

TypeinterventionalSponsorInstituto de Assistencia Medica ao Servidor Publico Estadual, Sao PauloRan2022 to 2026Enrolled180ConditionsHealthcare-Associated Pneumonia, Ventilator Associated PneumoniaArmsHydrocortisone, Placebo
3 · Its place in the literature

Who cites it

179 citing papers in PubMed, 23 syntheses or guidelines pooled it.

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  2. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025
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  12. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020
    Pooled it
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  15. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2019
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  16. Guideline
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  18. Corticosteroids for pneumonia.The Cochrane database of systematic reviews · 2017
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119 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Claudine Angela BlumEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Medical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
Nicole NigroEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Matthias BrielBasel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Philipp SchuetzMedical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
Elke UllmerMedical University Clinic, Kantonsspital Baselland/Liestal, Liestal, Switzerland.
Isabelle Suter-WidmerEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Bettina WinzelerEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Roland BingisserEmergency Department, University Hospital Basel, Basel, Switzerland.
Hanno ElsaesserMedical University Clinic, Kantonsspital Baselland/Liestal, Liestal, Switzerland.
Daniel DrozdovMedical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
Birsen AriciEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Medical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
Sandrine Andrea UrwylerEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Julie RefardtEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Philip TarrMedical University Clinic, Kantonsspital Baselland/Bruderholz, Bruderholz, Switzerland.
Sebastian WirzMedical University Clinic, Kantonsspital Baselland/Bruderholz, Bruderholz, Switzerland.
Robert ThomannDepartment of Internal Medicine, Bürgerspital, Solothurn, Switzerland.
Christine BaumgartnerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Hervé DuplainClinic of Internal Medicine, Hôpital du Jura, Site de Delémont, Delémont, Switzerland.
Dieter BurkiViollier AG, Postfach, Basel, Switzerland.
Werner ZimmerliMedical University Clinic, Kantonsspital Baselland/Liestal, Liestal, Switzerland.
Nicolas RodondiDepartment of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Beat MuellerMedical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland.
Mirjam Christ-CrainEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland. Electronic address: mirjam.christ@usb.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical 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.

methodsIn 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 ClinicalTrials.gov, number NCT00973154.

findingsFrom 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<0·0001). Pneumonia-associated complications until day 30 did not differ between groups (11 [3%] in the prednisone group and 22 [6%] in the placebo group; odds ratio [OR] 0·49 [95% CI 0·23-1·02]; p=0·056). The prednisone group had a higher incidence of in-hospital hyperglycaemia needing insulin treatment (76 [19%] vs 43 [11%]; OR 1·96, 95% CI 1·31-2·93, p=0·0010). Other adverse events compatible with corticosteroid use were rare and similar in both groups.

interpretationPrednisone treatment for 7 days in patients with community-acquired pneumonia admitted to hospital shortens time to clinical stability without an increase in complications. This finding is relevant from a patient perspective and an important determinant of hospital costs and efficiency.

fundingSwiss National Science Foundation, Viollier AG, Nora van Meeuwen Haefliger Stiftung, Julia und Gottfried Bangerter-Rhyner Stiftung.

Indexed as

AgedAged, 80 and overAnti-Bacterial AgentsAnti-Inflammatory AgentsCommunity-Acquired InfectionsDouble-Blind MethodDrug Administration ScheduleDrug Therapy, CombinationFemaleHospitalizationHumansIntention to Treat AnalysisMaleMiddle AgedPneumoniaPrednisoneAnti-Bacterial AgentsAnti-Inflammatory AgentsPrednisone

Identifiers

PMID25608756

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.