Adjunctive corticosteroid therapy for inpatients with Mycoplasma pneumoniae pneumonia.

Abstract

BACKGROUND:

There is conflicting evidence regarding the benefit of adjunctive corticosteroid therapy in patients with Mycoplasma pneumoniae pneumonia. We hypothesised that corticosteroid therapy could reduce mortality and length of stay (LOS) in such patients.

METHODS:

Adult patients with M. pneumoniae pneumonia from January 2010 to December 2013 were identified from the Japanese Diagnosis Procedure Combination inpatient database. The effects of low-dose and high-dose corticosteroid therapies on mortality, LOS, drug costs and hyperglycaemia requiring insulin treatment were evaluated using propensity score analyses.

RESULTS:

Eligible patients (n = 2228) from 630 hospitals were divided into no-corticosteroid (n = 1829), low-dose corticosteroid (n = 267) and high-dose corticosteroid (n = 132) groups. The propensity score-matched pairs were generated from no-corticoid and low-dose corticoid groups (251 pairs), or no-corticoid and high-dose corticosteroid groups (120 pairs). Adjunctive corticosteroid therapy did not decrease 30-day mortality. In addition, both low-dose and high-dose corticosteroid therapies were associated with increases in LOS. Furthermore, hyperglycaemia requiring insulin treatment and drug cost increased with corticosteroid use.

CONCLUSIONS:

Adjunctive treatment with low-dose or high-dose corticosteroids may not be beneficial in M. pneumoniae pneumonia.

• Authors: Masato Tashiro, Kiyohide Fushimi, Kei Kawano, Takahiro Takazono, Tomomi Saijo, Kazuko Yamamoto, Shintaro Kurihara, Yoshifumi Imamura, Taiga Miyazaki, Katsunori Yanagihara, Hiroshi Mukae, Koichi Izumikawa
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 17 Issue 1 Pg. 219 (Dec 29 2017) ISSN: 1471-2466 [Electronic] England
• PMID: 29284447 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Adult
• Aged
• Chemotherapy, Adjuvant
• Databases, Factual
• Dose-Response Relationship, Drug
• Female
• Humans
• Japan (epidemiology)
• Length of Stay (statistics & numerical data)
• Logistic Models
• Male
• Middle Aged
• Mycoplasma pneumoniae
• Pneumonia, Mycoplasma (drug therapy, mortality)
• Treatment Outcome
• Young Adult