TY - JOUR T1 - Adjunctive Corticosteroids for Pneumocystis jirovecii Pneumonia in Non-HIV-Infected Patients: A Systematic Review and Meta-Analysis of Observational Studies JO - Archivos de Bronconeumología T2 - AU - Fujikura,Yuji AU - Manabe,Toshie AU - Kawana,Akihiko AU - Kohno,Shigeru SN - 15792129 M3 - 10.1016/j.arbr.2016.08.002 DO - 10.1016/j.arbr.2016.08.002 UR - https://archbronconeumol.org/en-adjunctive-corticosteroids-for-pneumocystis-jirovecii-articulo-S1579212916301872 AB - IntroductionThe clinical benefits of adjunctive corticosteroids for Pneumocystis jirovecii pneumonia in patients not infected with the human immunodeficiency virus (HIV) has not been evaluated by meta-analysis. MethodsWe conducted a systematic review of published studies describing the effects of adjunctive corticosteroids on outcome in non-HIV P. jirovecii pneumonia patients. Two investigators independently searched the PubMed and Cochrane databases for eligible articles written in English. A meta-analysis was performed using a random-effects model for measuring mortality as the primary outcome, and the need for intubation or mechanical ventilation as the secondary outcome. ResultsSeven observational studies were eligible. In these studies, adjunctive corticosteroids did not affect mortality in non-HIV patients (odds ratio [OR] 1.26; 95% CI 0.60–2.67) and there was no beneficial effect in patients with severe hypoxemia (PaO2 <70mmHg) (OR 0.90; 95% CI 0.44–1.83). No significant effect on the secondary outcome was observed (OR 1.34; 95% CI 0.44–4.11). ConclusionsAlthough the studies were observational, meta-analysis showed that adjunctive corticosteroids did not improve the outcome of P. jirovecii pneumonia in non-HIV patients. The results warrant a randomized controlled trial. ER -