Abstract
背景Adjunctive intravenous corticosteroid treatment has shown to reduce length of stay (LOS) in adults hospitalised with community-acquired pneumonia (CAP). We aimed to assess the effect of oral dexamethasone on LOS and whether this effect is disease severity dependent.
Methods在这个多中心、分层随机、双-blind, placebo-controlled trial, immunocompetent adults with CAP were randomly assigned (1:1 ratio) to receive oral dexamethasone (6 mg once daily) or placebo for 4 days in four teaching hospitals in the Netherlands. Randomisation (blocks of four) was stratified by CAP severity (pneumonia severity index class I–III and IV-V). The primary outcome was LOS. This study is registered with ClinicalTrials.gov (nct01743755)。
Results2012年12月至2018年11月间,401名患者随机接受地塞米松(N = 203)或安慰剂(N = 198)。地塞米松组中位数洛杉矶(4.5天(95%(95%CI 4.0-5.0))比安慰剂组(5.0天(95%CI 4.6-5.4); P = 0.033)。在帽严重亚组中,治疗组之间的液体差异没有统计学意义。地塞米松臂中的二级ICU入学率下降(5(3%)versus14(7%),P = 0.030),30天的死亡率在组之间没有差异。在地塞米松集团的医院入院率趋于更高(20(10%)versus9.(5%); p=0.051) and hyperglycaemia (14 (7%)versus1(1%);p = 0.001)更普遍。
Conclusion口服地塞米松减少了用帽住院的成年人的LOS和ICU入学率。它仍然尚不清楚风险效益比的患者是最佳的。
Footnotes
This manuscript has recently been accepted for publication in theEuropean Respiratory Journal。它在汇款和排版的抄本之前在此处发布于其已接受的表单。在这些生产过程完成后,作者已批准所产生的证据,这篇文章将转向最新问题ERJonline. Please open or download the PDF to view this article.
Conflict of interest: Dr. Wittermans has nothing to disclose.
Conflict of interest: Dr. Vestjesn has nothing to disclose.
利益冲突:Spoorenberg博士无需披露。
利益冲突:Blok博士没有什么可披露的。
利益冲突:博士博士没有任何披露。
利益冲突:詹森博士无需披露。
利益冲突:Rijkers博士无需披露。
利益冲突:Smeenk博士无需披露。
Conflict of interest: Dr. Voorn has nothing to disclose.
Conflict of interest: Dr. van de Garde has nothing to disclose.
兴趣冲突:BOS博士报告了Zilveren Kruis保险的赠款,以外的工作;
- ReceivedJuly 3, 2020.
- 公认December 27, 2020.
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