Dexamethasone can reduce hospital stay in patients with community-acquired pneumonia

January 01, 0001

Dexamethasone can reduce hospital stay in patients with community-acquired pneumonia

The researchers aimed to assess effect of addition of dexamethasone on length of stay patients with community- acquired pneumonia not requiring intensive care. In a double-blind, placebo-controlled trial, they randomly assigned 304 adults aged 18 years or older with confirmed community-acquired pneumonia who presented to emergency departments of two teaching hospitals in the Netherlands to receive intravenous dexamethasone (5 mg once a day) or placebo for 4 days from admission. Patients were ineligible if they were immunocompromised, needed immediate transfer to an intensive-care unit, or were already receiving corticosteroids or immunosuppressive drugs.

47% of 304 enrolled patients had pneumonia of pneumonia severity index class 4—5 (52% patients in the dexamethasone group and 42% controls). Median length of stay was 6.5 days in the dexamethasone group compared with 7.5 days in the placebo group (significant). In-hospital mortality and severe adverse events were infrequent and rates did not differ between groups, although 44% of 151 patients in the dexamethasone group had hyperglycaemia compared with 23% of 153 controls (significant).

The researchers concluded: "Dexamethasone can reduce length of hospital stay when added to antibiotic treatment in non-immunocompromised patients with community- acquired pneumonia."

The cost savings can be considerable.

For the full abstract, click here.

The Lancet published online 1 June 2011
© 2011 Elsevier Limited
Dexamethasone and length of hospital stay in patients with community-acquired pneumonia. Sabine CA Meijvis, Hans Hardeman, Hilde HF Remmelts et al. Correspondence to Sabine CA Meijvis: [email protected]

Category: R. Respiratory. Keywords: dexamethasone, length, hospital, stay, community- acquired pneumonia, randomised, double-blind, placebo- controlled trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 10 June 2011

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