%0 Journal Article
%T Glucocorticosteroid in Treatment of Severe Pneumonia
%A Felinda Ariani
%A Kaixiong Liu
%A Zhang Jing
%A Jieming Qu
%J Mediators of Inflammation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/865635
%X Airway diseases such as pneumonia constitute a major health burden on a global scale; untreated pneumonia may develop to severe pneumonia and consequently lead to to fatal episodes of mortality and morbidity. The balance between inflammatory mediators is key for the outcome of the pulmonary infection; elimination of invading pathogen was marked by the release of cytokines and other inflammatory mediators from alveolar macrophages and glucocorticoid steroids (GCs) acting on the inflammatory component. Treatments of severe pneumonia with GCs have been developing for years with inconclusive results. In many cases GCs have been administered empirically without clinical evidence. Recent studies assess beneficial impact on treatment of severe pneumonia by suggesting specific dosage, period of administration, and tapered dosage. 1. Background Severe pneumonia patients represent a major concern for physicians because of the high mortality and morbidity rate attributed to these episodes [1]. During past decades, many strategies have been implemented with the aim of optimizing the outcome of patients with severe lung infections. State of immunocompromisation during severe pneumonia related to multiple drug-resistant infections which may contribute to severe hypoxemic respiratory failure triggering septic shock and fatal outcome associated with multiple organ dysfunction syndromes. Not only is colonizing of bacteria responsible as main coordinators but it is believed that excessive inflammatory cascade is also responsible in the core of immune reaction. Nowadays, antimicrobial therapy not completely enough to significantly reduce mortality number in severe pneumonia, additional therapy such GCs may constitute an important portion for better resolution of pneumonia. If not treated properly, severe pneumonia can eventually lead to several complications including acute respiratory distress syndrome (ARDS) and sepsis. They are characterized by persistent pulmonary inflammation and alveolar-capillary disruption and commonly affect critically ill patients, with an estimated mortality rate of more than 50% [2]. We reviewed recent reports to clarify whether systemic corticosteroids have an impact on the outcomes of patients with severe pneumonia. In addition, we explored possible explanations for the role mechanism of corticosteroid in severe pneumonia. 2. Role of Glucocorticosteroid in Sepsis and ARDS ARDS is common and frequently fatal; two pathological feature of lung derived from pulmonary fibrosis and sepsis, secondary to pneumonia, are the primary etiology of death
%U http://www.hindawi.com/journals/mi/2013/865635/