corticosteroids and icu course of community acquired pneumonia in egyptian settings糖皮质激素和icu的社区获得性肺炎在埃及设置.pdfVIP

Pharmacology Pharmacy, 2011, 2, 73-81 73 doi:10.4236/pp.2011.22009 Published Online April 2011 (http://www.SciRP.org/journal/pp) Corticosteroids and ICU Course of Community Acquired Pneumonia in Egyptian Settings 1 2 Nirmeen A. Sabry , Emad El-Din Omar 1Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt; 2Department of Critical Care Medicine, Fac- ulty of Medicine, Cairo University, Cairo, Egypt. Email: papers.sabry@ nd th st Received February 2 , 2011; revised February 12 , 2011; accepted February 21 , 2011. ABSTRACT Background : Pneumonia is the most common cause of community-acquired infection requiring ICU admission. 60% - 87% of patients with severe community acquired pneumonia (CAP) admitted to the ICU develops respiratory failure and require mechanical ventilation (MV). Objectives: To assess the efficacy and safety of adjunctive low dose hydrocortisone infusion treatment in Egyptian ICU patients with CAP. Methods : Hospitalized patients, clinically and radiologically diagnosed with CAP, were randomized to receive hydrocortisone 12.5 mg/h IV infusion for 7 days or placebo, along with antibiotics. The end-points of the study were improvement in PaO :FIO (PaO :FIO 300 or ≥ 100 increase from study 2 2 2 2 entry) and SOFA score by study day 8 and the development of delayed septic shock. Results : 80 patients were recruited, 40 of them received hydrocortisone and the remaining 40 received placebo. By study day 8, hydrocortisone treated pa- tients showed a significant improvement in PaO :FIO and chest radiograph score, and a signi