The study enrolled patients aged 18 years or older with community-acquired pneumonia from seven tertiary care hospitals in Switzerland, within 24 h of presentation. Patients were randomised to receive either adjunct prednisone 50 mg daily for 7 days or placebo. The primary endpoint was time to clinical stability defined as time (days) until stable vital signs for at least 24 h, which was reported to be shorter in the prednisone group (3.0 days, IQR 2.5–3.4) than in the placebo group (4.4 days, 4.0–5.0; hazard ratio [HR] 1.33, 95% CI 1.15–1.50, p<0.0001). The prednisone group had a higher incidence of in-hospital hyperglycaemia needing insulin treatment (76 [19%] vs 43 [11%]; OR 1.96, 95% CI 1.31–2.93, p=0.0010).
A related editorial discusses the results of this study, suggesting that the addition of a glucocorticosteroid would translate into cost savings considering these patients were discharged 1 day earlier compared to those on placebo.
DRAFT NICE guidelines (June 2014) on the diagnosis and management of community-and hospital-acquired pneumonia in adults states that glucocorticosteroids should not routinely be offered to patients with moderate- to severe-community-acquired pneumonia unless they have other conditions for which glucocorticosteroid treatment is indicated.