TY - JOUR T1 - Effects of Inhaled Corticosteroids on Pneumonia Severity and Antimicrobial Resistance JF - Respiratory Care SP - 1489 LP - 1494 DO - 10.4187/respcare.02191 VL - 58 IS - 9 AU - Oriol Sibila AU - Elena Laserna AU - Eric M Mortensen AU - Antonio Anzueto AU - Marcos I Restrepo Y1 - 2013/09/01 UR - http://rc.rcjournal.com/content/58/9/1489.abstract N2 - BACKGROUND: Limited information is available regarding the impact of prior use of inhaled corticosteroids (ICS) in patients subsequently developing community-acquired pneumonia (CAP). We assessed the effects of prior ICS use on severity of illness and microbiology in CAP hospitalized patients. METHODS: A retrospective cohort study of subjects with CAP (by the International Classification of Diseases, 9th Revision, Clinical Modification) was conducted over a 4-year period at 2 tertiary teaching hospitals. Subjects were considered to be ICS users if they received ICS prior to admission. Primary outcomes were severity of illness and microbiology at admission. RESULTS: Data were abstracted on 664 subjects: 89 prior ICS users (13.4%) and 575 non-users (86.6%). Prior ICS users had higher severity of illness at admission: mean ± SD Pneumonia Severity Index 100.8 ± 31.4 vs 68.8 ± 33.4, P = .001, and CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, ≥ 65 years of age) score 1.56 ± 1.02 vs 1.19 ± 1.02, P = .002. Prior ICS use was independently associated with antimicrobial-resistant pathogens: 11.2% vs 5.9%, odds ratio 2.6, 95% CI 1.1–6.1, P = .04. CONCLUSIONS: Prior ICS use was associated with higher severity of illness at admission and higher incidence of antimicrobial-resistant pathogens in CAP hospitalized patients. ER -