Community-acquired pneumonia (CAP) is a common disorder in children. The treatment options for CAP in pediatric populations are inhalation therapy and initiation of appropriate antibiotic therapy. Occasionally, CAP may progress to more severe pneumonia despite appropriate therapy. The benefit of systemic steroids such as dexamethasone as adjunctive treatment in children with CAP remains uncertain. The aim of the present study was to determine the efficacy of dexamethasone on childhood CAP whose symptoms worsened despite appropriate treatment.
Methods:
We retrospectively evaluated the effect of dexamethasone administration in 92 children with CAP whose clinical and radiographic course deteriorated despite broad-spectrum antibiotics.
Results:
The mean (±SD) age was 2.6 (± 2.3) years, and 55 (59.8%) were boys. All children had received appropriate antibiotics at admission, but they had persistent fever and/or progressively worsening radiographic findings. In addition to broad-spectrum antimicrobial therapy, dexamethasone (0.3 mg/kg) was administered. The mean days of dexamethasone use were 2.7 ± 1.4 days. Eighty-four children (91.1%) became afebrile within 24 hr, and their clinical status and radiographic findings improved within several days. Their clinical status and radiographic findings improved within several days. The mean lengths of hospitalization were 4.5 ± 2.4 days.
Conclusions:
Dexamethasone therapy appeared to be effective in reducing morbidity and is associated with clinical and radiographic improvement. Therefore, dexamethasone treatment may be beneficial for reducing morbidity in children with community-acquired pneumonia.