TY - JOUR 
A1 - Tagarro García, Alfredo
AU - Otheo, Enrique
AU - Baquero Artigao, Fernando
AU - Navarro, María Luisa
AU - Velasco, Rosa
AU - Ruiz, Marta
AU - Penín, María
AU - Moreno, David
AU - Rojo, Pablo
AU - Madero, Rosario
AU - Sanz Rosa, David
AU - Thuissard Vasallo, Israel John
AU - CORTEEC Study Group
T1 - Dexamethasone for Parapneumonic Pleural Effusion: A Randomized, Double-Blind, Clinical Trial
Y1 - 2017
SN - 00223476
UR - http://hdl.handle.net/11268/6606
AB - OBJECTIVE:
To assess whether dexamethasone (DXM) decreases the time to recovery in patients with parapneumonic pleural effusion.
STUDY DESIGN:
This was a multicenter, randomized, double blind, parallel-group, placebo-controlled clinical trial of 60 children, ranging in age from 1 month to 14 years, with community-acquired pneumonia (CAP) and pleural effusion. Patients received either intravenous DXM (0.25?mg/kg/dose) or placebo every 6 hours over a period of 48 hours, along with antibiotics. The primary endpoint was the time to recovery in hours, defined objectively. We also evaluated complications and adverse events.
RESULTS:
Among the 60 randomized patients (mean age, 4.7 years; 58% female), 57 (95%) completed the study. Compared with placebo recipients, the patients receiving DXM had a shorter time to recovery, after adjustment by severity group and stratification by center (hazard ratio, 1.95; 95% CI, 1.10-3.45; P?=?.021). The median time to recovery for patients receiving DXM was 68 hours (2.8 days) shorter than patients receiving placebo (109 hours vs 177 hours; P?=?.037). In exploratory subgroup analysis, the median time to recovery for patients with simple effusion receiving DXM was 76 hours (3.1 days) shorter than for patients with simple effusion receiving placebo (P?=?.017). The median time to recovery for patients with complicated effusion receiving DXM was 14 hours (0.5 days) shorter than for patients with complicated effusion receiving placebo (P?=?.66). The difference in the effect of DXM in the 2 severity groups was not statistically significant (P?=?.138 for interaction). There were no significant differences in complications or adverse events attributable to the study drugs, except for hyperglycemia.
CONCLUSION:
In this trial, DXM seemed to be a safe and effective adjunctive therapy for parapneumonic pleural effusion.
KW - Neumonía
KW - Corticosteroides
KW - Pediatría
KW - Pediatría
KW - Aparato respiratorio
LA - eng
ER -