SynthesisPloS one2015
Adjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02835040 (Evaluating the Impact of a New Model of Care Designed to Improve Evidence-based Management of Community-acquired Pneumonia), which is not on this map. Cited by 18 papers, 2 of them syntheses that pooled 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.
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.
Evaluating the Impact of a New Model of Care Designed to Improve Evidence-based Management of Community-acquired Pneumonia
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Corticosteroids as adjunctive therapy in the treatment of influenza.The Cochrane database of systematic reviews · 2019Pooled it
- Corticosteroids for pneumonia.The Cochrane database of systematic reviews · 2017Pooled it
- Glucocorticoid Therapy in COVID-19.Seminars in respiratory and critical care medicine · 2023Review
- Real-world corticosteroid use in severe pneumonia: a propensity-score-matched study.Critical care (London, England) · 2021Observational
- Article
- Adjunct corticosteroid treatment in patients with pneumonia: A precision medicine approach.Bosnian journal of basic medical sciences · 2019Review
- Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers.World journal of critical care medicine · 2019Review
- A novel counterbalanced implementation study design: methodological description and application to implementation research.Implementation science : IS · 2019Article
- Challenges in severe community-acquired pneumonia: a point-of-view review.Intensive care medicine · 2019Review
- Adjuvant therapies in critical care: steroids to treat infectious diseases.Intensive care medicine · 2018Article
- Adjuvant therapies in critical care: steroids in community-acquired pneumonia.Intensive care medicine · 2018Article
- Article
- South African guideline for the management of community-acquired pneumonia in adults.Journal of thoracic disease · 2017Review
- Severe Pneumonia Caused by Legionella pneumophila: Differential Diagnosis and Therapeutic Considerations.Infectious disease clinics of North America · 2017Review
- Pneumonia, Acute Respiratory Distress Syndrome, and Early Immune-Modulator Therapy.International journal of molecular sciences · 2017Review
- How Antibiotics Should be Prescribed to Hospitalized Elderly Patients with Community-Acquired Pneumonia.Drugs & aging · 2017Review
- Nonantibiotic Adjunctive Therapies for Community-Acquired Pneumonia (Corticosteroids and Beyond): Where Are We with Them?Seminars in respiratory and critical care medicine · 2016Review
- Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials.Journal of thoracic disease · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity-acquired pneumonia (CAP) induces lung and systemic inflammation, leading to high morbidity and mortality. We systematically reviewed the risks and benefits of adjunctive corticotherapy in the management of patients with CAP.
methodsWe systematically searched Pubmed, Embase and the Cochrane Library for randomized controlled trials comparing adjunctive corticotherapy and antimicrobial therapy with antimicrobial therapy alone in patients with CAP. The primary outcome was 30-day mortality. Secondary outcomes were length of hospital stay, time to clinical stability and severe complications.
results14 trials (2077 patients) were included. The reported 30-day mortality was 7.9% (80/1018) among patients treated with adjunctive corticotherapy versus 8.3% (85/1028) among patients treated with antimicrobial therapy alone (RR 0.84; 95%CI 0.55 to1.29). Adjunctive corticotherapy was associated with a reduction of severe complications (RR 0.36; 95%CI 0.23 to 0.56), a shorter length of stay (9.0 days; 95%CI 7.6 to 10.7 vs 10.6 days; 95%CI 7.4 to 15.3) and a shorter time to clinical stability (3.3 days; 95% CI 2.8 to 4.1 vs 4.3 days; 95%CI 3.6 to 5.1). The risk of hyperglycemia was higher among patients treated with adjunctive corticotherapy (RR 1.59; 95%CI 1.06 to 2.38), whereas the risk of gastro-intestinal bleeding was similar (RR 0.83; 95%CI 0.35 to 1.93). In the subgroup analysis based on CAP severity, a survival benefit was found among patients with severe CAP (RR 0.47; 95%CI 0.23 to 0.96).
conclusionAdjunctive corticotherapy is associated with a reduction of length of stay, time to clinical stability, and severe complications among patients with CAP, but the effect on mortality remains uncertain.
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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.