Patients with a community-acquired pneumonia who are admitted to the hospital.
Conditions
Interventions
Sponsors
None listed
Eligibility
Inclusion criteria
Inclusion criteria: Patients aged 18 to 100 years with a community-acquired pneumonia which requires admission. Criteria to determine a community-acquired pneumonia: - Chest radiograph showing new opacities. In combination with two of the following findings: 0 Cough 0 Production of sputum 0 Temp >38,0 °C or 10.000 cells/mm3), leftward shift (>10%) or leucopenia ( 15 mg/l (three fold higher than the upper limit of normal) Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 300 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 300
Exclusion criteria
Exclusion criteria: - Immunocompromised patients: 0 Patients with a known congenital or acquired immunodeficiency. 0 Patients who received chemotherapy less than 6 weeks ago. 0 Patients who received corticosteroids in the last 6 weeks. 0 Patients who received immunosuppressive medication in the last 6 weeks (e.g. cyclosporin, cyclophosphamide, azathioprine). 0 Patients with COPD who are on systemic corticosteroids for COPD. - Patients who require ICU treatment. - Patients with tropical worm infection. - Patients with dexamethasone intolerance. - Pregnant and breastfeeding women.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: The effect of dexamethasone on clinical outcome in patients admitted with CAP; Primary end point(s): Length of hospital stay. ;Timepoint(s) of evaluation of this end point: When all 600 patients are included.; Secondary Objective: Study what patients admitted with CAP benefit most from dexamethasone therapy. Predefined subgroup analysis based on: o disease severity score (PSI 1-3 vs. PSI 4-5); o CRP level at admission; o causative microorganism (Pneumococcus antigentest positive vs. negative); o cytokine response (IL-6 and IL-10) over time; o cortisol level over time; o procalcitonin over time. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): - in-hospital mortality - one-year mortality ;Timepoint(s) of evaluation of this end point: When all 600 patients are included. | — |
Countries
Netherlands