Core IM | Internal Medicine Podcast
#141 Do Steroids Have a Role in Community-Acquired Pneumonia? Beyond Journal Club on the CAPE COD Trial
Dec 6, 2023
Exploring the use of steroids in community-acquired pneumonia (CAP), discussing conflicting findings, the CAPE COD trial, and the potential for improved outcomes. Analyzing the impact of steroids on CAP mortality rates, including significant reduction in mortality risk. Discussing whether the findings should change clinical practice for severe pneumonia. Exploring the use of steroids in hypoxic and unresponsive patients, highlighting the need for further research.
22:07
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Quick takeaways
- Steroids can be beneficial in treating severe community-acquired pneumonia by reducing mortality and the need for intubation or vasopressors.
- Previous inconsistencies in studies on steroids for pneumonia have been addressed by the positive results of the Cape Cod Trial, providing valuable insights for the use of steroids in selected severe pneumonia patients.
Deep dives
Rationale for using glucocorticoids in infections and pneumonia
During an infection, inflammation is a key component of the body's defense mechanisms. However, an excessive inflammatory response can cause harm. Steroids, with their anti-inflammatory properties, have been considered as potential treatment options for infections, including pneumonia, which is characterized by inflammation in the lungs. Steroids could help curb the immune response in the lungs and improve outcomes. However, steroids are not without side effects, such as hyperglycemia, GI bleeding, infections, and neuropsychiatric effects.
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