Uso de hidrocortisona en la etapa inicial de la neumonía grave de la comunidad

Abstract

Introduction: community-acquired pneumonia is a problem that affects the health systems of developed and underdeveloped countries, it represents the sixth cause of death in general and the first in infectious pathologies, with a mortality rate of 8 to 15% globally. The severity depends on criteria elaborated by scientific societies, which offer guidelines for management and adjuvant systemic corticosteroids. General objective: to describe the current evidence supporting the clinical benefit of the use of hydrocortisone in patients with severe community-acquired pneumonia. Methodology: a narrative literature review was conducted on the use of hydrocortisone in patients with severe community-acquired pneumonia, which is developed from a strategy of articulated search related to the research topic in scientific bases, in addition meta-analysis, systematic reviews and randomized clinical trials were considered, which demonstrate the usefulness of hydrocortisone as adjunctive treatment in community-acquired pneumonia. Results: adjunctive therapy with hydrocortisone was shown to be beneficial for certain phenotypes with severe community-acquired pneumonia, it was shown to reduce mortality, hospital stay, risk of mechanical ventilation or its duration, it may be associated with hospital readmission and hyperglycemia, however, it was not associated with an increase in nosocomial infections or gastrointestinal bleeding. Conclusion: it is important as physicians caring for critically ill patients to find information from certified guidelines endorsed by competent local and international scientific bodies and institutions, in order to implement the best therapy for patients with severe community-acquired pneumonia.