Adjunctive corticosteroid therapy and clinical recovery in hospitalized community-acquired pneumonia patients: a retrospective comparative study

Irma Rostalina; Made Laksmi Meiliana; Mega Ayu Kusniawati

doi:10.51511/pr.111

Irma Rostalina Department of Pharmacy, Adila College of Health Sciences, Bandar Lampung, Indonesia
Made Laksmi Meiliana Department of Pharmacy, Adila College of Health Sciences, Bandar Lampung, Indonesia
Mega Ayu Kusniawati Department of Pharmacy, Adila College of Health Sciences, Bandar Lampung, Indonesia

Keywords: adjunctive therapy, community-acquired pneumonia, corticosteroids, hospitalization, respiratory outcomes

Abstract

Dysregulated inflammation in community-acquired pneumonia (CAP) has prompted investigation of corticosteroids as adjunctive therapy; however, their clinical utility remains contested, particularly in non-severe presentations and resource-limited settings. This study aims to evaluate the effect of adjunctive corticosteroid therapy on length of hospital stay and key clinical parameters in adult CAP patients at a secondary referral hospital in Bandar Lampung, Indonesia. This retrospective comparative study analyzed medical records of 59 eligible CAP patients admitted during 2023. Patients were categorized into steroid (n = 39) and non-steroid (n = 20) groups. Time to clinical improvement in temperature, cough, dyspnea, and respiratory rate, as well as length of hospital stay, were compared using chi-square and Fisher's exact tests. Steroid-treated patients had significantly longer hospital stays (28.2% vs. 5.0% with stays ≥5 days; p = 0.044), slower dyspnea resolution (p = 0.022), and delayed respiratory rate normalization (p = 0.042). No significant differences were observed for temperature (p = 0.653) or cough resolution (p = 0.679). Adjunctive corticosteroid therapy was not associated with clinical benefit in this cohort and was associated with prolonged hospitalization. Severity-based patient selection and standardized protocols are essential before routine corticosteroid use can be recommended in similar settings.

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