Efficacy and safety of glucocorticoids therapy of severe community-acquired pneumonia in older adults: a systematic review and meta-analysis

Table 1 Characteristics of the included studies

Study	Country	Severe criterion	Study Design	Number of Sites	Sample		Mean age(y)	Corticosteroid Type	Corticosteriod Dosage	Cumulative Hydrocortisone Dose (mg)^✳	Corticosteroid duration(d)
Study	Country	Severe criterion	Study Design	Number of Sites	n	N	Mean age(y)	Corticosteroid Type	Corticosteriod Dosage	Cumulative Hydrocortisone Dose (mg)^✳	Corticosteroid duration(d)
Confalonier 2005 [9]	Italy	ATS	DB RCT	6	23	23	63.5	Hydrocortisone	Intravenous 200 mg IV bolus; followed 10 mg/hour IV	1880	7
Snijders 2010 [10]	Netherlands	PSI	DB RCT	1	48	45	63.51	Prednisolone	40 mg oral or IV daily	1120	7
Sabry 2011 [11]	Egypt	ATS	DB RCT	2	40	40	62.22	Hydrocortisone	200 mg IV bolus then maintenance dose of 12.5 mg/h	2300	7
Sui,DongJiang 2013 [12]	China	BTS	RCT	1	30	30	62.71	Methylprednisolone	40 mg IV twice daily on days 1–3 and 8 mg oral twice daily on days 4–7	1440	7
Torres 2015 [13]	Spain	ATS	DB RCT	3	61	59	65.29	Methylprednisolone	0.5 mg/kg IV twice daily	1750	5
Chu,ZiDong 2018 [14]	China	NR	RCT	1	50	50	70.5	Methylprednisolone	40 mg IV twice daily on days 1–3 and 8 mg oral twice daily on days 4–7	1440	7
Wittermans 2021 [15]	Netherlands	PSI	DB RCT	4	77	79	76.51	Dexamethason	6 mg oral daily	638.4	4
Meduri 2022 [16]	USA	ATS	DB RCT	42	297	287	68.8	Methylprednisolone	40 mg bolus followed by 40 mg daily on days 1–7, 20 mg daily on days 8–14, 12 mg daily on days 15–17 and 4 mg daily on days 18–20	2540	20
Dequin 2023 [8]	France	PSI	DB RCT	31	400	395	67	Hydrocortisone	IV 200 mg daily for either 4 or 8 days, followed by tapering for 8 or 14 days	1000	8/14

ATS = American Thoracic Society, BTS = British Thoracic Society,PSI = Pneumonia Severity Index,DB = double-blind, RCT = randomized controlled trial,N = the number of patients in the control group, n = the number of patients in the corticosteroids group,NR = Not reported, IV = intravenous,Severe community-acquired pneumonia is defined as PSI of IV or V, CURB-65 ≥ 2;Meeting ATS-IDSA 2007 rule where 1 major or 3 minor criteria were satisfied; BTS ≥ 3;
^✳The total steroid dose administered during the treatment course was reported as the cumulative dose, with all corticosteroids standardized to hydrocortisone-equivalent doses. For studies that reported dosages per kilogram of body weight, calculations were based on a 70 kg elderly individual

ISSN: 1471-2318