Randomized controlled trial: the safety and efficacy of adjunctive corticosteroids through the clinical course of severe hospital-acquired pneumonia

Background Pneumonia acquired in hospitals (HAP) is a nosocomial infection that poses the greatest risk of death and serious sequelae. Aim This study’s objective was to assess safety and efficacy of adjunctive systemic steroids in individuals who have severe HAP including ventilator-associated pneumonia. Patients and methods The present randomized controlled clinical study was conducted at the Chest Department and Respiratory Intensive Care Unit (RICU) in Assiut University Hospitals, 50 patients diagnosed with severe and very severe HAP using the Pneumonia Severity Index were randomly divided into two groups: group I (steroid group) and group II (control group). Results The median age was 60 and 67 years (steroid group and control group), respectively. Cortisol-level measurement before administration of systemic steroids was in normal range in both groups with no significant difference. Adjunctive steroid use in the management of severe HAP was linked to a statistically significant improvement in oxygenation data at the 7 th day, as well as a reduction in the duration of hospital stay and duration required to reach clinical stability. Steroid therapy did not show significant difference in ICU mortality, the length of time that mechanical ventilation is used, and hospital stay. Regarding the complications of steroid therapy, there were no significance differences between both groups. Conclusion Adding steroid has the potential to increase oxygenation and minimize the time it takes for clinical stability in patients with severe HAP without causing obvious side effects.