Preadmission Corticosteroid Therapy and the Risk of Respiratory Failure in Adults Without HIV Presenting With Pneumocystis Pneumonia.

Journal of Intensive Care Medicine
Patrick M WieruszewskiAndrew H Limper

Abstract

Corticosteroid therapy is a well-recognized risk factor for Pneumocystis pneumonia (PCP); however, it has also been proposed as an adjunct to decrease inflammation and respiratory failure. To determine the association between preadmission corticosteroid use and risk of moderate-to-severe respiratory failure at the time of PCP presentation. This retrospective cohort study evaluated HIV-negative immunosuppressed adults diagnosed with PCP at Mayo Clinic from 2006 to 2016. Multivariable regression models were used to evaluate the association between preadmission corticosteroid exposure and moderate-to-severe respiratory failure at presentation. Of the 323 patients included, 174 (54%) used preadmission corticosteroids with a median daily dosage of 20 (interquartile range: 10-40) mg of prednisone or equivalent. After adjustment for baseline demographics, preadmission corticosteroid therapy did not decrease respiratory failure at the time of PCP presentation (odds ratio: 1.23, 95% confidence interval: 0.73-2.09, P = .38). Additionally, after adjusting for inpatient corticosteroid administration, preadmission corticosteroid use did not impact the need for intensive care unit admission (P = .98), mechanical ventilation (P = .92), or 30-...Continue Reading

References

Mar 26, 2003·Seminars in Respiratory Infections·Peter Y Hahn, Andrew H Limper
Oct 11, 2003·Journal of Clinical Pharmacology·Donald E MagerWilliam J Jusko
Mar 17, 2007·Nature Reviews. Microbiology·Charles F Thomas, Andrew H Limper
Aug 26, 2010·Therapeutic Advances in Respiratory Disease·Eva M Carmona, Andrew H Limper
Mar 30, 2016·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Anne-Lise BienvenuStéphane Picot
Jan 19, 2018·Journal of Intensive Care Medicine·Gil Myeong SeongJin Won Huh
Oct 30, 2018·World Journal of Critical Care Medicine·Patrick M WieruszewskiHemang Yadav

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Citations

Mar 4, 2020·Journal of Fungi·Camila BonicheCarlos Pelleschi Taborda
May 25, 2021·Seminars in Respiratory and Critical Care Medicine·Cassie C KennedyRaymund R Razonable

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Methods Mentioned

BETA
bronchoalveolar lavage

Software Mentioned

R for
SAS
R

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