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Corticosteroids as Adjunctive Treatment in Community-Acquired Pneumonia

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Annual Update in Intensive Care and Emergency Medicine 2014

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM,volume 2014))

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Abstract

Community-acquired pneumonia (CAP) is the leading cause of morbidity and mortality from infectious diseases in developed countries. It affects more than 5 million adults and accounts for more than 1 million admissions each year in the United States. Pneumonia is the sixth leading cause of death worldwide, and age-adjusted mortality is increasing. Despite effective antibiotic therapy, about 12–36 % patients admitted to the intensive care unit (ICU) with severe CAP die within a short period of time. Development of an efficacious adjunctive treatment, therefore, has important implications for reducing this high attributable mortality.

During infectious pneumonia, the arrival of pathogens in the lung creates a complex inflammatory response, with the interaction of several defense mechanisms and the production of a number of inflammatory mediators and acute phase proteins. The aim of this inflammatory response is to control progression of the infection. If the reaction is over proportioned, various systemic consequences can negatively influence the clinical progression of the infection. On the other hand, an excessive host inflammatory response is related to poor outcomes in CAP. Elevated cytokine release has been linked to treatment failure, ICU admission and mortality.

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Sibila, O., Ferrer, M., Torres, A. (2014). Corticosteroids as Adjunctive Treatment in Community-Acquired Pneumonia. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2014. Annual Update in Intensive Care and Emergency Medicine, vol 2014. Springer, Cham. https://doi.org/10.1007/978-3-319-03746-2_5

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  • DOI: https://doi.org/10.1007/978-3-319-03746-2_5

  • Publisher Name: Springer, Cham

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