Adjunctive Corticosteroid Therapy in Community-Acquired Pneumonia: A Literature Review of Efficacy, Safety, and Patient Selection Criteria
DOI:
https://doi.org/10.36557/2674-8169.2026v8n6p1061-1076Keywords:
community-acquired pneumonia, corticosteroids, pneumoniaAbstract
Community-acquired pneumonia (CAP) remains one of the leading causes of infectious morbidity and mortality worldwide, particularly in severe cases that frequently progress to respiratory failure, sepsis, and the need for intensive care support. Corticosteroids have been investigated as adjunctive therapy due to their potential to modulate the exaggerated inflammatory response associated with the disease. The objective of this review was to critically analyze the available evidence regarding the potential benefits and risks of corticosteroid use in community-acquired pneumonia, aiming to provide support for evidence-based clinical decision-making. This literature review was conducted using the National Library of Medicine (PubMed) and the Biblioteca Virtual em Saúde (BVS) databases, employing the descriptors “Pneumonia,” “Corticosteroids,” and “Community-Acquired Pneumonia.” Articles published between 2016 and 2025, available in full text, and classified as randomized clinical trials, controlled clinical trials, or analyses derived from randomized clinical trials were included. Duplicate articles and studies not directly related to the proposed topic were excluded. Sixteen studies evaluating different corticosteroid regimens in patients with CAP were analyzed. The findings demonstrated that corticosteroids may reduce mortality, the need for invasive mechanical ventilation, vasopressor use, and the time to clinical stability, particularly among patients with severe disease and an intense inflammatory response. However, conflicting results were observed across the studies, and adverse effects, especially hyperglycemia, were frequently reported, in addition to potential late complications such as secondary infections and recurrent pneumonia. Therefore, corticosteroids represent a promising therapeutic strategy for specific subgroups of patients with CAP, provided that their use is individualized and supported by scientific evidence.
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Copyright (c) 2026 Gustavo Alves Henderson Cardoso, Mariana Alfena Ostwald, Ana Clara Pinheiro Andrade, João Victor Macedo de Oliveira, Juliana Silveira Sola, Luan Gabriel Affonso, Maria Victória da Costa Farfan, Milla Daudt Ribeiro, Ramon Fraga de Souza Lima
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