{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:44:17Z","timestamp":1790347457363,"version":"4.1.0"},"reference-count":45,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Critical Care"],"published-print":{"date-parts":[[2024,4]]},"DOI":"10.1016\/j.jcrc.2023.154507","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T01:48:50Z","timestamp":1703123330000},"page":"154507","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":43,"special_numbering":"C","title":["Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1016","volume":"80","author":[{"given":"Huzaifa Ahmad","family":"Cheema","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeena","family":"Musheer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arooba","family":"Ejaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anousheh Awais","family":"Paracha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abia","family":"Shahid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ebad Ur","family":"Rehman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa Hamza","family":"Hermis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Duric","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faran","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharjeel","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Szakmany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcrc.2023.154507_bb0005","series-title":"Community-acquired pneumonia. Pharmacol Ther","first-page":"1081","author":"Haas","year":"2009"},{"key":"10.1016\/j.jcrc.2023.154507_bb0010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165942","article-title":"Efficacy and safety of adjunctive corticosteroids therapy for severe community-acquired pneumonia in adults: an updated systematic review and Meta-analysis","volume":"11","author":"Bi","year":"2016","journal-title":"PloS One"},{"key":"10.1016\/j.jcrc.2023.154507_bb0015","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/MCP.0000000000000760","article-title":"New guidelines for severe community-acquired pneumonia","volume":"27","author":"Martin-Loeches","year":"2021","journal-title":"Curr Opin Pulm Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0020","article-title":"Management of pneumonia in critically ill patients","volume":"375","author":"Cill\u00f3niz","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0025","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1093\/cid\/cix801","article-title":"Corticosteroids in patients hospitalized with community-acquired pneumonia: systematic review and individual patient data Metaanalysis","volume":"66","author":"Briel","year":"2018","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jcrc.2023.154507_bb0030","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1001\/archinte.167.15.1655","article-title":"Understanding the inflammatory cytokine response in pneumonia and Sepsis","volume":"167","author":"Kellum","year":"2007","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0035","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/j.chest.2020.07.089","article-title":"International perspective on the new 2019 American Thoracic Society\/Infectious Diseases Society of America Community-acquired pneumonia guideline: a critical appraisal by a global expert panel","volume":"158","author":"Pletz","year":"2020","journal-title":"Chest"},{"key":"10.1016\/j.jcrc.2023.154507_bb0040","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1136\/thoraxjnl-2015-206881","article-title":"British Thoracic Society community acquired pneumonia guideline and the NICE pneumonia guideline: how they fit together","volume":"70","author":"Lim","year":"2015","journal-title":"Thorax"},{"key":"10.1016\/j.jcrc.2023.154507_bb0045","article-title":"ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of severe community-acquired pneumonia","author":"Martin-Loeches","year":"2023","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0050","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.21037\/jtd.2017.05.31","article-title":"South African guideline for the management of community-acquired pneumonia in adults","volume":"9","author":"Boyles","year":"2017","journal-title":"J Thorac Dis"},{"key":"10.1016\/j.jcrc.2023.154507_bb0055","article-title":"Efficacy and safety of adjunctive corticosteroids therapy for patients with severe community-acquired pneumonia","volume":"98","author":"Huang","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.jcrc.2023.154507_bb0060","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.chest.2022.08.2229","article-title":"Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia","volume":"163","author":"Saleem","year":"2023","journal-title":"Chest"},{"key":"10.1016\/j.jcrc.2023.154507_bb0065","article-title":"Efficacy and safety of glucocorticoids in the treatment of severe community-acquired pneumonia","volume":"98","author":"Jiang","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.jcrc.2023.154507_bb0070","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s13054-023-04561-z","article-title":"Efficacy and safety of adjunctive corticosteroids in the treatment of severe community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials","volume":"27","author":"Wu","year":"2023","journal-title":"Crit Care"},{"key":"10.1016\/j.jcrc.2023.154507_bb0075","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2215145","article-title":"Hydrocortisone in severe community-acquired pneumonia","author":"Dequin","year":"2023","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0080","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0085","series-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins","year":"2019"},{"key":"10.1016\/j.jcrc.2023.154507_bb0090","article-title":"Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis","volume":"359","author":"L\u00f3pez-L\u00f3pez","year":"2017","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0095","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0100","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1136\/bmj.39490.551019.BE","article-title":"What is \u201cquality of evidence\u201d and why is it important to clinicians?","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0105","doi-asserted-by":"crossref","first-page":"73","DOI":"10.4236\/pp.2011.22009","article-title":"Corticosteroids and ICU course of community acquired pneumonia in Egyptian settings","volume":"02","author":"Sabry","year":"2011","journal-title":"Pharmacol Pharm"},{"key":"10.1016\/j.jcrc.2023.154507_bb0110","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1164\/rccm.200406-808OC","article-title":"Hydrocortisone infusion for severe community-acquired pneumonia","volume":"171","author":"Confalonieri","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0115","first-page":"91","article-title":"Effects of low-dose hydrocortisone in ICU patients with severe community-acquired pneumonia","volume":"55","author":"El-Ghamrawy","year":"2006","journal-title":"Egypt J Chest Dis Tuberc"},{"key":"10.1016\/j.jcrc.2023.154507_bb0120","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jama.2015.88","article-title":"Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response","volume":"313","author":"Torres","year":"2015","journal-title":"JAMA"},{"key":"10.1016\/j.jcrc.2023.154507_bb0125","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1378\/chest.104.2.389","article-title":"Hydrocortisone and tumor necrosis factor in severe community-acquired pneumonia: a randomized controlled study","volume":"104","author":"Marik","year":"1993","journal-title":"Chest"},{"key":"10.1016\/j.jcrc.2023.154507_bb0130","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00134-022-06684-3","article-title":"Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia","volume":"48","author":"Meduri","year":"2022","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0135","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/bmj.4.5840.569","article-title":"Ampicillin dosage and use of prednisolone in treatment of pneumonia: co-operative controlled trial","volume":"4","author":"McHardy","year":"1972","journal-title":"BMJ"},{"key":"10.1016\/j.jcrc.2023.154507_bb0140","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1164\/rccm.200905-0808OC","article-title":"Efficacy of corticosteroids in community-acquired pneumonia: a randomized double-blinded clinical trial","volume":"181","author":"Snijders","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0145","first-page":"58","article-title":"Adjunctive treatment with oral dexamethasone in non-ICU patients hospitalised with community-acquired pneumonia: a randomised clinical trial","author":"Wittermans","year":"2021","journal-title":"Eur Respir J"},{"key":"10.1016\/j.jcrc.2023.154507_bb0150","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/S0140-6736(11)60607-7","article-title":"Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial","volume":"377","author":"Meijvis","year":"2011","journal-title":"Lancet"},{"key":"10.1016\/j.jcrc.2023.154507_bb0155","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00408-007-9020-3","article-title":"Efficacy of corticosteroids in the treatment of community-acquired pneumonia requiring hospitalization","volume":"185","author":"Mikami","year":"2007","journal-title":"Lung"},{"key":"10.1016\/j.jcrc.2023.154507_bb0160","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1016\/S0140-6736(14)62447-8","article-title":"Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial","volume":"385","author":"Blum","year":"2015","journal-title":"Lancet"},{"key":"10.1016\/j.jcrc.2023.154507_bb0165","first-page":"15","article-title":"Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial","author":"Fern\u00e1ndez-Serrano","year":"2011","journal-title":"Crit Care"},{"key":"10.1016\/j.jcrc.2023.154507_bb0170","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.ejcdt.2013.03.009","article-title":"Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia","volume":"62","author":"Nafae","year":"2013","journal-title":"Egypt J Chest Dis Tuberc"},{"key":"10.1016\/j.jcrc.2023.154507_bb0175","first-page":"CD007720","article-title":"Corticosteroids for pneumonia","volume":"2017","author":"Stern","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.jcrc.2023.154507_bb0180","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/8755122521995587","article-title":"Corticosteroids in community-acquired pneumonia: a review of current literature","volume":"37","author":"Harris","year":"2021","journal-title":"J Pharm Technol"},{"key":"10.1016\/j.jcrc.2023.154507_bb0185","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1007\/s00134-020-06289-8","article-title":"Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS","volume":"46","author":"Meduri","year":"2020","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0190","first-page":"197","article-title":"The effect of hydrocortisone upon the course of pneumococcal pneumonia treated with penicillin","volume":"98","author":"Wagner","year":"1956","journal-title":"Bull Johns Hopkins Hosp"},{"key":"10.1016\/j.jcrc.2023.154507_bb0195","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1001\/jamainternmed.2019.1438","article-title":"Effectiveness of a bundled intervention including adjunctive corticosteroids on outcomes of hospitalized patients with community-acquired pneumonia","volume":"179","author":"Lloyd","year":"2019","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0200","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1186\/s13054-023-04614-3","article-title":"Effects of corticosteroids on severe community-acquired pneumonia: a closer look at the evidence","volume":"27","author":"Chiang","year":"2023","journal-title":"Crit Care"},{"key":"10.1016\/j.jcrc.2023.154507_bb0205","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1186\/s13054-023-04576-6","article-title":"Letter to the Editor Regarding \u201cEfficacy and safety of adjunctive corticosteroids in the treatment of severe community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials\u201d","volume":"27","author":"Wang","year":"2023","journal-title":"Crit Care"},{"key":"10.1016\/j.jcrc.2023.154507_bb0210","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1111\/anae.13870","article-title":"The use of enrichment to reduce statistically indeterminate or negative trials in critical care","volume":"72","author":"Shankar-Hari","year":"2017","journal-title":"Anaesthesia"},{"key":"10.1016\/j.jcrc.2023.154507_bb0215","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1001\/jama.2020.17023","article-title":"Association between Administration of Systemic Corticosteroids and Mortality among Critically ill Patients with COVID-19: a Meta-analysis","volume":"324","author":"Sterne","year":"2020","journal-title":"JAMA"},{"key":"10.1016\/j.jcrc.2023.154507_bb0220","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1080\/17476348.2023.2177155","article-title":"Safety and efficacy of glucocorticoids in the treatment of COVID-19: a meta-analysis of randomized control trials","volume":"17","author":"Qiao","year":"2023","journal-title":"Expert Rev Respir Med"},{"key":"10.1016\/j.jcrc.2023.154507_bb0225","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJMoa2021436","article-title":"Dexamethasone in hospitalized patients with Covid-19","volume":"384","author":"Horby","year":"2021","journal-title":"N Engl J Med"}],"container-title":["Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883944123002563?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883944123002563?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:51:42Z","timestamp":1760125902000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883944123002563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":45,"alternative-id":["S0883944123002563"],"URL":"https:\/\/doi.org\/10.1016\/j.jcrc.2023.154507","relation":{},"ISSN":["0883-9441"],"issn-type":[{"value":"0883-9441","type":"print"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials","name":"articletitle","label":"Article Title"},{"value":"Journal of Critical Care","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcrc.2023.154507","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"154507"}}