tailieunhanh - Báo cáo khoa học: "Clinical review: A systematic review of corticosteroid use in infections"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical review: A systematic review of corticosteroid use in infections. | Available online http content 10 1 203 Review Clinical review A systematic review of corticosteroid use in infections Jody Aberdein1 and Mervyn Singer2 Senior House Officer Department of Intensive Care Medicine University College London Hospitals NHS Trust Mortimer St London W1T 3AA UK 2Professor Dept of Intensive Care Medicine University College London Hospitals NHS Trust Mortimer St London W1T 3AA UK Corresponding author Mervyn Singer Published 22 November 2005 Critical Care 2006 10 203 doi cc3904 This article is online at http content 10 1 203 2005 BioMed Central Ltd Abstract Traditional teaching suggests that corticosteroids should be avoided during acute infectious episodes for fear of compromising the immune response. However the outcome benefit shown through steroid administration in early septic shock implies this paranoia may be misplaced. We therefore performed a systematic review of the literature to identify the current strength of evidence for the use of corticosteroids in specified infections and to make appropriate graded recommendations. Introduction Traditional teaching suggests that corticosteroids impair the ability of the body to fight infection and that this may prove catastrophic if an appropriate antibiotic is not chosen. In recent years however the early use of steroid therapy has become progressively established in a wide range of infective conditions 1 2 including septic shock its most severe systemic manifestation. We thus decided to conduct a systematic review of the literature to identify the current strength of evidence for the use of corticosteroids in specified infections and to make appropriate graded recommendations. Methodology The Cochrane Database of Systematic Reviews the Database of Abstracts of Reviews of Effects DARE and the Cochrane Central Register of Controlled Trials CENTRAL issue 1 2005 were searched using medical subject headings MeSH for steroids glucocorticoids .