Skip to main content
Erschienen in: Intensive Care Medicine 8/2016

14.09.2015 | What's New in Intensive Care

What’s new in severe community-acquired pneumonia? Corticosteroids as adjunctive treatment to antibiotics

verfasst von: Antoni Torres, Miquel Ferrer

Erschienen in: Intensive Care Medicine | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Excerpt

Severity criteria occur in up to 18 % of hospitalized patients with community-acquired pneumonia (CAP), and still carry a high morbidity and mortality. In a French multicentre study on severe pneumococcal CAP admitted to intensive care units (ICU), the overall mortality rate was 29 %, with high proportions of patients in septic shock and needing mechanical ventilation [1]. Patients with severe CAP (SCAP) might die despite an early and adequate antibiotic treatment. This is probably due, in part, to a misbalanced and disproportionate local and systemic inflammatory response that contributes to impairment of gas exchange, sepsis and end-organ dysfunction [2]. …
Literatur
1.
Zurück zum Zitat Mongardon N, Max A, Bougle A, Pene F, Lemiale V, Charpentier J, Cariou A, Chiche JD, Bedos JP, Mira JP (2012) Epidemiology and outcome of severe pneumococcal pneumonia admitted to intensive care unit: a multicenter study. Crit Care 16:R155CrossRefPubMedPubMedCentral Mongardon N, Max A, Bougle A, Pene F, Lemiale V, Charpentier J, Cariou A, Chiche JD, Bedos JP, Mira JP (2012) Epidemiology and outcome of severe pneumococcal pneumonia admitted to intensive care unit: a multicenter study. Crit Care 16:R155CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Monton C, Ewig S, Torres A, El Ebiary M, Filella X, Rano A, Xaubet A (1999) Role of glucocorticoids on inflammatory response in nonimmunosuppressed patients with pneumonia: a pilot study. Eur Respir J 14:218–220CrossRefPubMed Monton C, Ewig S, Torres A, El Ebiary M, Filella X, Rano A, Xaubet A (1999) Role of glucocorticoids on inflammatory response in nonimmunosuppressed patients with pneumonia: a pilot study. Eur Respir J 14:218–220CrossRefPubMed
4.
Zurück zum Zitat Sibila O, Luna CM, Agusti C, Baquero S, Gando S, Patron JR, Morato JG, Absi R, Bassi N, Torres A (2008) Effects of glucocorticoids in ventilated piglets with severe pneumonia. Eur Respir J 32:1037–1046CrossRefPubMed Sibila O, Luna CM, Agusti C, Baquero S, Gando S, Patron JR, Morato JG, Absi R, Bassi N, Torres A (2008) Effects of glucocorticoids in ventilated piglets with severe pneumonia. Eur Respir J 32:1037–1046CrossRefPubMed
5.
Zurück zum Zitat Nie W, Zhang Y, Cheng J, Xiu Q (2012) Corticosteroids in the treatment of community-acquired pneumonia in adults: a meta-analysis. PLoS ONE 7:e47926CrossRefPubMedPubMedCentral Nie W, Zhang Y, Cheng J, Xiu Q (2012) Corticosteroids in the treatment of community-acquired pneumonia in adults: a meta-analysis. PLoS ONE 7:e47926CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Siemieniuk RA, Meade MO, Onso-Coello P, Briel M, Evaniew N, Prasad M, Alexander PE, Fei Y, Vandvik PO, Loeb M, Guyatt GH (2015) Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med. doi:10.7326/M15-0715 (epub ahead of print) PubMed Siemieniuk RA, Meade MO, Onso-Coello P, Briel M, Evaniew N, Prasad M, Alexander PE, Fei Y, Vandvik PO, Loeb M, Guyatt GH (2015) Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med. doi:10.​7326/​M15-0715 (epub ahead of print) PubMed
7.
Zurück zum Zitat Menendez R, Martinez R, Reyes S, Mensa J, Filella X, Marcos MA, Martinez A, Esquinas C, Ramirez P, Torres A (2009) Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax 64:587–591CrossRefPubMed Menendez R, Martinez R, Reyes S, Mensa J, Filella X, Marcos MA, Martinez A, Esquinas C, Ramirez P, Torres A (2009) Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax 64:587–591CrossRefPubMed
8.
Zurück zum Zitat Chalmers JD, Smith MP, McHugh BJ, Doherty C, Govan JR, Hill AT (2012) Short- and long-term antibiotic treatment reduces airway and systemic inflammation in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 186:657–665CrossRefPubMed Chalmers JD, Smith MP, McHugh BJ, Doherty C, Govan JR, Hill AT (2012) Short- and long-term antibiotic treatment reduces airway and systemic inflammation in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 186:657–665CrossRefPubMed
9.
Zurück zum Zitat Torres A, Sibila O, Ferrer M, Polverino E, Menendez R, Mensa J, Gabarrus A, Sellares J, Restrepo MI, Anzueto A, Niederman MS, Agusti C (2015) Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA 313:677–686CrossRefPubMed Torres A, Sibila O, Ferrer M, Polverino E, Menendez R, Mensa J, Gabarrus A, Sellares J, Restrepo MI, Anzueto A, Niederman MS, Agusti C (2015) Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA 313:677–686CrossRefPubMed
10.
Zurück zum Zitat Menendez R, Torres A, Zalacain R, Aspa J, Martin Villasclaras JJ, Borderias L, Benitez Moya JM, Ruiz-Manzano J, Rodriguez de Castro F, Blanquer J, Perez D, Puzo C, Sanchez GF, Gallardo J, Alvarez C, Molinos L (2004) Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome. Thorax 59:960–965CrossRefPubMedPubMedCentral Menendez R, Torres A, Zalacain R, Aspa J, Martin Villasclaras JJ, Borderias L, Benitez Moya JM, Ruiz-Manzano J, Rodriguez de Castro F, Blanquer J, Perez D, Puzo C, Sanchez GF, Gallardo J, Alvarez C, Molinos L (2004) Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome. Thorax 59:960–965CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Wunderink RG (2015) Corticosteroids for severe community-acquired pneumonia: not for everyone. JAMA 313:673–674CrossRefPubMed Wunderink RG (2015) Corticosteroids for severe community-acquired pneumonia: not for everyone. JAMA 313:673–674CrossRefPubMed
12.
Zurück zum Zitat Lee N, Leo YS, Cao B, Chan PK, Kyaw WM, Uyeki TM, Tam WW, Cheung CS, Yung IM, Li H, Gu L, Liu Y, Liu Z, Qu J, Hui DS (2015) Neuraminidase inhibitors, superinfection and corticosteroids affect survival of influenza patients. Eur Respir J 45:1642–1652CrossRefPubMed Lee N, Leo YS, Cao B, Chan PK, Kyaw WM, Uyeki TM, Tam WW, Cheung CS, Yung IM, Li H, Gu L, Liu Y, Liu Z, Qu J, Hui DS (2015) Neuraminidase inhibitors, superinfection and corticosteroids affect survival of influenza patients. Eur Respir J 45:1642–1652CrossRefPubMed
13.
Zurück zum Zitat Timsit JF, Perner A, Bakker J, Bassetti M, Benoit D, Cecconi M, Curtis JR, Doig GS, Herridge M, Jaber S, Joannidis M, Papazian L, Peters MJ, Singer P, Smith M, Soares M, Torres A, Vieillard-Baron A, Citerio G, Azoulay E (2015) Year in review in intensive care medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics. Intensive Care Med 41:575–588CrossRefPubMedPubMedCentral Timsit JF, Perner A, Bakker J, Bassetti M, Benoit D, Cecconi M, Curtis JR, Doig GS, Herridge M, Jaber S, Joannidis M, Papazian L, Peters MJ, Singer P, Smith M, Soares M, Torres A, Vieillard-Baron A, Citerio G, Azoulay E (2015) Year in review in intensive care medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics. Intensive Care Med 41:575–588CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG (2007) Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 44(Suppl 2):S27–S72CrossRefPubMed Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG (2007) Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 44(Suppl 2):S27–S72CrossRefPubMed
Metadaten
Titel
What’s new in severe community-acquired pneumonia? Corticosteroids as adjunctive treatment to antibiotics
verfasst von
Antoni Torres
Miquel Ferrer
Publikationsdatum
14.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 8/2016
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-4042-4

Weitere Artikel der Ausgabe 8/2016

Intensive Care Medicine 8/2016 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.