Corticosteroid use does not appear to increase infectious complications in non-COVID-19 pneumonia

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. Corticosteroid use does not appear to increase infectious complications in non-COVID-19 pneumonia

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03055

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04312

URL goes live when the embargo lifts             

A systematic review and meta-analysis evaluated the association between corticosteroid therapy, mortality, and infectious complications in adults with severe non-COVID-19 pneumonia or acute respiratory distress syndrome (ARDs). The review found that adjunct corticosteroids probably reduce short-term mortality in cases of severe pneumonia and ARDS and may reduce secondary shock in severe pneumonia. The findings are published in Annals of Internal Medicine. 

Researchers from Hôpital La Pitié Salpêtrière and Sorbonne University analyzed 20 randomized controlled trials comprising 3,459 participants that compared systemic corticosteroids with placebo and usual care. The primary analysis included studies using corticosteroids at 3 mg/kg or less per day, for 15 days or less, initiated within 7 days of pneumonia or ARDS onset. The review found that adjunct corticosteroids probably reduce short-term mortality in both severe pneumonia and ARDs, but evidence for their effect on long-term mortality remains uncertain. In severe pneumonia, they may reduce secondary shock but have little effect on hospital-acquired infections and secondary pneumonia in both severe pneumonia and ARDs. The evidence is very uncertain about the effect on catheter-related infections in both conditions. The findings suggest that there is no evidence of increased infectious complications with corticosteroid use for pneumonia, which is one of the main concerns regarding corticosteroid use for non-COVID-19 pneumonia.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Rayan Braïk, MD, MSc, please email service.presse@aphp.fr.

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2. Physician outlines best practices and resources for addressing gun violence with patients

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03900

URL goes live when the embargo lifts             

In an opinion piece published in Annals of Internal Medicine, Sue Bornstein, MD, MACP reflects on the decades-long history of gun violence in America and offers recommendations and resources for physicians to use when addressing gun violence with their patients. Dr. Bornstein refers to the American College of Physicians’ stance that physicians should counsel their patients about mitigating the risks associated with firearms in the home, and shares solutions to common barriers physicians say prevent them from counseling patients on firearm safety. These barriers include lack of time in the clinical encounter, concerns about offending patients, lack of familiarity with guns and legal protections for health care professionals, and inadequate resources for screening and counseling. Since there is no clear consensus on whether universal or risk-based screening for firearm injury risk is preferable, Dr. Bornstein says to use the approach that best aligns with their practice setting. She reinforces that it is the ethical duty of physicians to prevent harm associated with firearms and gun violence.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Sue Bornstein, MD, MACP please email suebornstein@gmail.com.

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Also new this issue:

Asheville, North Carolina: The Origin of the American Tuberculosis Sanitarium Movement

David O. Freedman, MD

History of Medicine

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02861