Relationship between the Use of Inhaled Steroids for Chronic Respiratory Diseases and Early Outcomes in Community-Acquired Pneumonia
Open Access
- 5 September 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (9), e73271
- https://doi.org/10.1371/journal.pone.0073271
Abstract
The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP). We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality). Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%). In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002) in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787). This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542), with COPD alone (OR=4.68, p=0.194), but a protective effect was observed in CB patients (OR=0.15, p=0.027). Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis.Keywords
This publication has 22 references indexed in Scilit:
- Inhaled drugs as risk factors for community-acquired pneumoniaEuropean Respiratory Journal, 2010
- Inhaled corticosteroid use is associated with lower mortality for subjects with COPD and hospitalised with pneumoniaEuropean Respiratory Journal, 2010
- Inhaled corticosteroids and risk of pneumonia: evidence for and against the proposed associationQJM: An International Journal of Medicine, 2010
- Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study resultsEuropean Respiratory Journal, 2009
- New evidence of risk factors for community-acquired pneumonia: a population-based studyEuropean Respiratory Journal, 2008
- Combined corticosteroid and long-acting beta-agonist in one inhaler versus long-acting beta-agonists for chronic obstructive pulmonary diseasePublished by Wiley ,2007
- Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation studyThorax, 2003
- Risk factors for community-acquired pneumonia diagnosed by general practitioners in the communityRespiratory Medicine, 2000
- Prospective study on the etiology of community-acquired pneumonia in children and adults in SpainEuropean Journal of Clinical Microbiology & Infectious Diseases, 1988
- PROSPECTIVE STUDY OF THE AETIOLOGY AND OUTCOME OF PNEUMONIA IN THE COMMUNITYThe Lancet, 1987