Efficacy Studies of Corticosteroid Therapy in Community-Acquired Pneumonia

The CAPISCE-Trial: Community-Acquired Pneumonia; an Intervention Study With Corticosteroids

The purpose of this study is to determine the efficacy of addition of corticosteroid therapy to antibiotics in patient admitted with Community-acquired pneumonia.

The hypothesis is: Prednisolone in combination with antibiotic treatments is effective in improving clinical outcome in patients hospitalized with CAP.

Community-acquired pneumonia (CAP) is a acute illness with a considerable morbidity and mortality, especially patients with severe CAP. In the past decennia, in spite of many investigations, little reduction is seen in morbidity an mortality. Corticosteroids have a immune-modulation effect, which is not completely elucidated. Most likely the immune modulation effect is due to down-regulation of pro-inflammatory cytokines. The use of corticosteroids next to antibiotics in CAP could lead to shorter time to clinical stability, length of stay and costs.

Comparison: Hospitalized patients with CAP treated with antibiotics and prednisolone versus hospitalized patients with cap treated with antibiotics and placebo

Inclusion Criteria:

Clinical symptoms of community-acquired pneumonia:

• Fever, cough, sputum, pleural pain, dyspnoea
• Radiological symptoms of pneumoniä

Exclusion Criteria:

• Any conditions wich requires corticosteroid therapy.
• Pregnancy of lactation
• Malignancy
• Immune-compromised patients (eg chemotherapy or AIDS)
• Pre-treatment with macrolide for >24 hours