Trial reportThe European respiratory journal2016
Pathogen- and antibiotic-specific effects of prednisone in community-acquired pneumonia.
Trial report in The European respiratory journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 5 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Systemic administration of glucocorticoids, cardiovascular complications and mortality in patients hospitalised with COVID-19, SARS, MERS or influenza: A systematic review and meta-analysis of randomised trials.Pharmacological research · 2022Pooled it
- Pooled it
- Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis.Scientific reports · 2020Pooled it
- Corticosteroids as adjunctive therapy in the treatment of influenza.The Cochrane database of systematic reviews · 2019Pooled it
- Influence of Prednisone on Inflammatory Biomarkers in Community-Acquired Pneumonia: Secondary Analysis of a Randomized Trial.Journal of clinical pharmacology · 2021Trial
- Trial
- Glucocorticoid Treatment in Community-Acquired Pneumonia.Seminars in respiratory and critical care medicine · 2026Review
- Flawed design and selection bias in critical care randomized controlled trials (RCTs): the patient safety risk of the "RCT mimic".Patient safety in surgery · 2025Review
- A narrative review of the pathophysiology of sepsis in sub-Saharan Africa: Exploring the potential for corticosteroid therapy.PLOS global public health · 2025Review
- Identifying subgroup of severe community-acquired pneumonia based on clinical metagenomics, a multicenter retrospective cohort study.Frontiers in cellular and infection microbiology · 2024Article
- Glucocorticoid Therapy in COVID-19.Seminars in respiratory and critical care medicine · 2023Review
- Derivation and Validation of a Novel Severity Scoring System for Pneumonia at Intensive Care Unit Admission.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Mendelson's syndrome complicated by bacterial aspiration pneumonia triggered by right putamen bleeding: A case report.Respiratory medicine case reports · 2021Article
- Corticosteroids for Community-Acquired Pneumonia: Overstated Benefits and Understated Risks.Chest · 2019Article
- Gut Microbiota Contributes to Resistance Against Pneumococcal Pneumonia in Immunodeficient RagFrontiers in cellular and infection microbiology · 2018Article
- Antibiotic therapy, supportive treatment and management of immunomodulation-inflammation response in community acquired pneumonia: review of recommendations.Multidisciplinary respiratory medicine · 2017Review
- Secondary infections in critically ill patients with COVID-19 receiving steroid therapy.Science progressArticle
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In a double-blind, randomised, placebo-controlled trial of hospitalised patients with community-acquired pneumonia (CAP), we demonstrated shorter time to clinical stability (TTCS) with adjunct corticosteroid therapy compared with placebo.We did a pre-planned, exploratory analysis of any association between microbiological diagnosis, antibiotic treatment and procalcitonin level and effect of prednisone on TTCS, mortality, and CAP complications (n=726 participants, enrolled between December 2009 and May 2014). Multiplex viral real time PCR was systematically performed in nasopharyngeal swabs beginning November 2011 (n=489). Other investigations and treatments were at the discretion of the physician. Effect modification was tested with inclusion of interaction terms in the statistical models.Reduced TTCS with prednisone was seen in all microbiological, antibiotic, procalcitonin and afebrile patient subgroups. We found evidence for a different prednisone response in patients with pneumococcal pneumonia in whom intravenous antibiotic duration was not shorter (interaction p=0.01) with prednisone, as was observed in the remaining study population. In patients without macrolide treatment, rehospitalisations were not lower with prednisone (interaction p=0.04). After adjustment for multiple testing, these subgroup effects were no longer significant.Prednisone was associated with shorter TTCS independent of CAP aetiology. In pneumococcal pneumonia, prednisone effects on secondary endpoints may be less favourable.
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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.