Effect of adjunctive corticosteroid therapy on length of hospital stay and clinical outcomes in community-acquired pneumonia patients

Irma Rostalina; Made Laksmi Meiliana; Mega Ayu Kusniawati

doi:10.51511/pr.111

Irma Rostalina Program Studi Farmasi, Sekolah Tinggi Ilmu Kesehatan Adila
Made Laksmi Meiliana Program Studi Farmasi, Sekolah Tinggi Ilmu Kesehatan Adila
Mega Ayu Kusniawati Program Studi Farmasi, Sekolah Tinggi Ilmu Kesehatan Adila

Keywords: community-acquired pneumonia, corticosteroids, hospitalization, respiratory rate, treatment outcome

Abstract

Community-acquired pneumonia remains a major cause of morbidity and mortality despite antibiotic therapy. Corticosteroids may modulate excessive inflammatory responses by suppressing pro-inflammatory cytokines, but their clinical utility remains controversial. To evaluate the effect of adjunctive corticosteroid therapy on length of hospital stay and clinical parameters in community-acquired pneumonia patients. This retrospective observational study analyzed medical records of 59 community-acquired pneumonia patients at Hospital X, Bandar Lampung, during 2023. Patients were categorized into steroid (n=39) and non-steroid (n=20) groups. Clinical parameters including fever, cough, dyspnea, respiratory rate, and length of hospital stay were compared using chi-square analysis. Significant differences were observed in length of stay (p=0.044), dyspnea resolution (p=0.022), and respiratory rate normalization (p=0.042), with the steroid group showing longer durations. No significant differences were found in fever (p=0.653) and cough resolution (p=0.679). Adjunctive corticosteroid therapy did not demonstrate clinical benefit in this population and was associated with prolonged hospital stay, suggesting the need for careful patient selection and standardized protocols.

References

Kemenkes RI. Profil Kesehatan Indonesia 2020. 2021.

Wulandari N, Kusuma IY. Rasionalitas penggunaan antibiotik pada pasien pneumonia anak di RSUD Prof. Dr. Margono Soekarjo Purwokerto. Seminar Nasional Penelitian dan Pengabdian Kepada Masyarakat (SNPPKM). 2021; 405–411.

Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200: e45–e67. doi:10.1164/rccm.201908-1581ST

Harris LK, Crannage AJ. Corticosteroids in community-acquired pneumonia: A review of current literature. Journal of Pharmacy Technology. 2021;37: 152–160.

Herdwiyanti M, Alisjahbana B, Santoso P. Pola dan kepekaan kuman biakan sputum serta karakteristik pasien pneumonia di RSUP Dr. Hasan Sadikin Bandung. Tunas Medika Jurnal Kedokteran & Kesehatan. 2021;7: 1–9.

Meiliana ML, Lestari YE. Pengaruh pemberian steroid sebagai terapi adjuvan terhadap parameter inflamasi pasien pneumonia komunitas berat di Rumah Sakit ``X’’ Kota Bandar Lampung. Jurnal Medika Malahayati. 2023;7: 1182–1191.

Kautsar M. Analisis faktor-faktor yang berhubungan dengan lama rawat inap pasien pneumonia di RSU Cut Meutia Aceh Utara. 2022.

Natasya FA. Tatalaksana pneumonia. Jurnal Medika Hutama. 2022;3: 2392–2399.

Ardyati S, Kurniawan NU, Darmawan E. Steroids effect as adjuvant therapy toward length of stay and clinical symptoms in pediatric with pneumonia. Indonesian Journal of Clinical Pharmacy. 2017;6: 181–189.

Anandita Y, Susanti R. Studi penggunaan obat antiinflamasi golongan steroid sebagai terapi adjuvan pada pasien pneumonia usia balita di RSUD Dr. Soedarso Pontianak. Jurnal Ilmiah Universitas Tanjungpura. 2020;10: 92–101.