{"id":29532,"date":"2025-11-04T04:53:00","date_gmt":"2025-11-03T20:53:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29532"},"modified":"2025-11-04T09:07:03","modified_gmt":"2025-11-04T01:07:03","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%b3%96%e7%9a%ae%e8%b4%a8%e6%bf%80%e7%b4%a0%e6%b2%bb%e7%96%97%e7%a4%be%e5%8c%ba%e8%8e%b7%e5%be%97%e6%80%a7%e8%82%ba%e7%82%8e%e7%9a%84%e5%ae%9e","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29532","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6cbb\u7597\u793e\u533a\u83b7\u5f97\u6027\u80ba\u708e\u7684\u5b9e\u7528\u6027\u4e34\u5e8a\u8bd5\u9a8c"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia<\/h1>\n\n\n\n

Ruth K.\u00a0Lucinde,\u00a0Henry\u00a0Gathuri,\u00a0B.Sc.,\u00a0Paul\u00a0Mwaniki,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med Published\u00a0October 29, 2025<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2507100<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

Adjunctive glucocorticoids may reduce mortality among patients with severe community-acquired pneumonia (CAP) in well-resourced settings. Whether these drugs are beneficial in low-resource settings with limited diagnostic and treatment facilities is unclear.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

In this pragmatic, open-label, randomized, controlled trial conducted in 18 public hospitals in Kenya, we assigned adult patients who had received a diagnosis of CAP and who did not have a clear indication for glucocorticoids to receive either standard care for CAP or oral low-dose glucocorticoids for 10 days in addition to standard care. The primary outcome was death from any cause at 30 days after enrollment.<\/p>\n\n\n\n

RESULTS<\/h3>\n\n\n\n

A total of 2180 patients underwent randomization (1089 assigned to the glucocorticoid group and 1091 to the standard-care group). The median age of the patients was 53 years (interquartile range, 38 to 72); 46% were women. At day 30, deaths were reported in 530 patients (24.3%): 246 patients (22.6%) in the glucocorticoid group and 284 patients (26.0%) in the standard-care group (hazard ratio, 0.84; 95% confidence interval, 0.73 to 0.97; P=0.02). The frequencies of adverse events and serious adverse events were similar in the two trial groups. Serious adverse events that were considered to be related to glucocorticoid administration occurred in 5 patients (0.5%).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

CONCLUSIONS<\/h3>\n\n\n\n

In patients with CAP in a low-resource setting, adjunctive glucocorticoid therapy was associated with a lower risk of death than standard care. (Funded by Wellcome Trust and others; SONIA PACTR number, PACTR202111481740832; ISRCTN number, ISRCTN36138594<\/a>.)<\/p>\n\n\n\n

<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE A Pragmatic Trial of Glucocorticoids f […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29532"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29532"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29532\/revisions"}],"predecessor-version":[{"id":29533,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29532\/revisions\/29533"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29532"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29532"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29532"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}