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Am Fam Physician. 2023;108(6):online

Author disclosure: No relevant financial relationships.

Details for This Review

Study Population: 1,689 adult patients with severe community-acquired pneumonia (CAP) from seven randomized controlled trials (RCTs) comparing adjunctive corticosteroids with placebo or standard care

Efficacy End Points: 30-day, all-cause mortality; requirement for mechanical ventilation; length of intensive care unit (ICU) stay; length of hospital stay

Harm End Points: Adverse events, including gastrointestinal bleeding, health care–associated infection, acute kidney injury, and hospital readmission

1 in 16 had lower risk of 30-day, all-cause mortalityNo harms; no significant difference reported for any adverse events (e.g., gastrointestinal bleeding, health care–associated infection, acute kidney injury, hospital readmission)
1 in 7 had lower risk of requiring mechanical ventilation
Reduced length of intensive care unit stay (mean difference = −0.8 day)
Reduced length of hospital stay (mean difference = −1.1 day)
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This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

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