tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2015 Jun 26. pii: S1198-743X(15)00681-3. doi: 10.1016/j.cmi.2015.06.022. [Epub ahead of print]
[h=1]Corticosteroid for the Treatment of Human infection with influenza virus: A systematic review and meta-analysis.[/h] Yang JW[SUP]1[/SUP], Fan LC[SUP]2[/SUP], Miao XY[SUP]2[/SUP], Mao B[SUP]1[/SUP], Li MH[SUP]1[/SUP], Lu HW[SUP]2[/SUP], Liang S[SUP]2[/SUP], Xu JF[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] Administration of corticosteroids to patients affected by influenza virus, especially pandemic avian influenza virus infection, although relatively common, remains controversial. A systematic review and meta-analysis was performed to assess the impact of corticosteroid therapy on outcomes of patients with influenza virus infection. PubMed, EMBASE, Web of Science and Cochrane Library databases were searched up to February, 2015. Studies comparing corticosteroid therapy to no corticosteroid therapy in patients with influenza virus infection were included. The primary outcomes assessed were the association of mortality and nosocomial infection with corticosteroid therapy. Two authors independently extracted the data. Odds ratio (OR) and weighted mean difference (WMD) were used to describe dichotomous data and continuous data, respectively. Nineteen studies with 4916 patients were included in this meta-analysis. Results showed that corticosteroid therapy was significantly associated with mortality [OR 1.98, 95% confidence interval (CI) 1.62-2.43, P<0.00001] and nosocomial infection (OR 3.16, 95% CI 2.09-4.78, P<0.00001). The duration of mechanical ventilation (MV) (MD 3.82, 95% CI 1.49-6.15, P=0.001) and Intensive Care Unit (ICU) stays (MD 4.78, 95% CI 2.27-7.29, P=0.0002) were both markedly longer in the corticosteroid therapy group than in the control group. These findings suggest that routine steroid use may not be ideal for influenza virus infection. However，these results derive from observational studies, with some important bias. They should be examined in future sufficiently powered randomized trials.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] corticosteroid; infection; influenza virus; meta-analysis; treatment; viral pneumonia
PMID: 26123860 [PubMed - as supplied by publisher]
[h=1]Corticosteroid for the Treatment of Human infection with influenza virus: A systematic review and meta-analysis.[/h] Yang JW[SUP]1[/SUP], Fan LC[SUP]2[/SUP], Miao XY[SUP]2[/SUP], Mao B[SUP]1[/SUP], Li MH[SUP]1[/SUP], Lu HW[SUP]2[/SUP], Liang S[SUP]2[/SUP], Xu JF[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] Administration of corticosteroids to patients affected by influenza virus, especially pandemic avian influenza virus infection, although relatively common, remains controversial. A systematic review and meta-analysis was performed to assess the impact of corticosteroid therapy on outcomes of patients with influenza virus infection. PubMed, EMBASE, Web of Science and Cochrane Library databases were searched up to February, 2015. Studies comparing corticosteroid therapy to no corticosteroid therapy in patients with influenza virus infection were included. The primary outcomes assessed were the association of mortality and nosocomial infection with corticosteroid therapy. Two authors independently extracted the data. Odds ratio (OR) and weighted mean difference (WMD) were used to describe dichotomous data and continuous data, respectively. Nineteen studies with 4916 patients were included in this meta-analysis. Results showed that corticosteroid therapy was significantly associated with mortality [OR 1.98, 95% confidence interval (CI) 1.62-2.43, P<0.00001] and nosocomial infection (OR 3.16, 95% CI 2.09-4.78, P<0.00001). The duration of mechanical ventilation (MV) (MD 3.82, 95% CI 1.49-6.15, P=0.001) and Intensive Care Unit (ICU) stays (MD 4.78, 95% CI 2.27-7.29, P=0.0002) were both markedly longer in the corticosteroid therapy group than in the control group. These findings suggest that routine steroid use may not be ideal for influenza virus infection. However，these results derive from observational studies, with some important bias. They should be examined in future sufficiently powered randomized trials.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] corticosteroid; infection; influenza virus; meta-analysis; treatment; viral pneumonia
PMID: 26123860 [PubMed - as supplied by publisher]