PT  - JOURNAL ARTICLE
AU  - Alejandra Lopez-Giraldo
AU  - Jacobo Sellarés
AU  - Carmen Lucena
AU  - Eva Polverino
AU  - Catia Cilloniz
AU  - Rosanel Amaro
AU  - Maria Angeles Marcos
AU  - Josep Mensa
AU  - Antoni Torres
TI  - Long-term use of inhaled corticoids on the development of pleural effusion in community-acquired pneumonia
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 2815
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/2815.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/2815.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - IntroductionLong-term use of inhaled corticosteroids (ICS) in patients with Chronic Obstructive Pulmonary Disease (COPD) has been associated with increase risk of CAP. Most recently, ICS have been associated with less severity of CAP and decreased risk of pneumonia-related mortality. Pleural infection is a frequent complication of CAP that may increase mortality. The aim of this study was to assess the influence of long-term use of ICS on the incidence and severity of parapneumonic effusion and empyiema in patients with different baseline respiratory diseases.MethodsWe conducted a single centre cohort study of 3602 patients consecutively collected with CAP. We assessed clinical, radiographic and pleural fluid chemistry and microbiological variables. Patients were classified whether they received prior long term ICS treatment or not.Results659 patients (18%) were treated with ICS before diagnosis of CAP (COPD: 56%). Long-term use of ICS was significant associated with less incidence of parapneumonic effusion compared to those without prior ICS treatment 5% vs. 12%, p<0.001. Multivariate analysis adjusted by sex, age, comorbidities and CAP severity showed a significant association between ICS treatment and lower incidence of pleural effusion (OR 0.42 (95% CI, 0.28-0.64, p<0.001). Prior treatment with ICS was significantly associated with lower incidence of empyiema compared to those without ICS treatment (3% vs 16%, p=0.05).ConclusionsLong-term use of ICS in patients who develop CAP is associated with lower incidence and less severity of parapneumonic effusion regardless of the baseline chronic respiratory condition.Supported by: CibeRes-ISCiii-CB06/06/0028 and IDIBAPS.