High–Dose Pulse Versus Nonpulse Corticosteroid Regimens in Severe Acute Respiratory Syndrome

• DOI: 10.1164/rccm.200306-766oc
• Publication Date: 2003-09-02T00:52:00Z
• Authors: James C. Ho; Gaik C. Ooi; Thomas Y. Mok; Johnny W. Chan; Ivan Hung; Bing Lam; Poon C. Wong; Patrick C. Li; Pak L. Ho; Wah K. Lam; Chun K. Ng; Mary S. Ip; Kar N. Lai; Moira Chan-Yeung; Kenneth W. Tsang
• Keywords: Regimen; Cumulative dose

The treatment of atypical pneumonia, subsequently termed severe acute respiratory syndrome (SARS), is controversial, and the efficacy corticosteroid therapy unknown. We have evaluated clinical radiographic outcomes 72 patients with probable SARS (median age 37 years, 30 M), who received ribavirin different steroid regimens in two regional hospitals. Chest radiographs were scored according to percentage lung field involved. Seventeen initially pulse (PS) (methylprednisolone ⩾ 500 mg/day) 55 nonpulse (NPS) < therapy. cumulative dosage; intensive care unit admission, mechanical ventilation, mortality rates; hematologic biochemical parameters similar both groups after 21 days. However, PS group had less oxygen requirement, better outcome, likelihood requiring rescue than their counterparts. There was no significant difference between hemolytic anemia, secondary infections, or hematemesis, but hyperglycaemia. Initial use methylprednisolone appears be a more efficacious an equally safe regimen when compared lower dosage should considered as preferred SARS, pending data from future randomized controlled trials.