brand logo

Am Fam Physician. 2015;92(6):528a-529

Clinical Question

Does adding prednisone to antibiotics improve outcomes in adults hospitalized with community-acquired pneumonia (CAP)?

Bottom Line

Among patients hospitalized with CAP, adjunctive prednisone speeds time to recovery by 1.5 days and shortens hospital length of stay by approximately one day, but produces no difference in pneumonia complications at 30 days. (Level of Evidence = 1b)


In this Swiss study, patients admitted to the hospital with CAP randomly received 50 mg of prednisone daily for seven days (n = 402) or placebo (n = 400). Each day, a researcher unaware of treatment assignment assessed the patients' clinical status. Patients treated with prednisone reached clinical stability (at least 24 hours of stable vital signs: afebrile, no tachycardia or tachypnea, normotensive, normal mental status, no hypoxia) approximately 1.5 days faster than patients treated with placebo. The average length of stay was one day longer in patients treated with placebo. The patients taking prednisone were more likely to have hyperglycemia treated with insulin.

Study design: Randomized controlled trial (double-blinded)

Funding source: Foundation

Allocation: Concealed

Setting: Inpatient (any location)

Reference: BlumCANigroNBrielMet alAdjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet2015; 385( 9977): 1511– 1518.

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to

This series is coordinated by Natasha J. Pyzocha, DO, contributing editor.

A collection of POEMs published in AFP is available at

Continue Reading

More in AFP

Copyright © 2015 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.