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Hydrocortisone for severe community acquired pneumonia in ICU

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Key learning points

  • Between 22% and 44% of adults with community-acquired pneumonia (CAP) require admission to hospital.

  • Previous studies suggest that glucocorticoids provide benefits in severe CAP, but with limited evidence of effect on mortality.

  • A placebo-controlled trial found that intravenous hydrocortisone reduced the risk of death in intensive care patients with severe CAP.

A randomised placebo-controlled study found that adding hydrocortisone to standard intensive care treatment for severe community-acquired pneumonia (CAP) reduced the risk of death by day 28.1


This randomised double-blind placebo-controlled trial, conducted across 31 centres in France, recruited adults admitted to an intensive care unit (ICU) for severe CAP.1 Exclusion criteria included pneumonia caused by influenza and septic shock. All patients were given standard therapy including antibiotics and supportive care. Patients in the intervention group received intravenous hydrocortisone administered continuously at a dose of 200mg per day during the …

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  • Contributors DTB Team.

  • Provenance and peer review Commissioned; internally peer reviewed.