#141 Do Steroids Have a Role in Community-Acquired Pneumonia? Beyond Journal Club on the CAPE COD Trial

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 6 December 2023

⏱️ 23 minutes

🔗️ Recording | iTunes | RSS

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Summary

In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.

Show Notes & Transcript

01:50 Pathophysiology of Steroids and Infection
03:50 Steroids in PNA Studies
08:56 CAPE COD Trial
14:13 Discussion of CAPE COD Trial
18:36 Takeaways/Discussion

Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant

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Transcript

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0:00.0	Welcome to the third installment of Beyond Journal Club, a collaboration between CoreIM and
0:04.3	any JM group.
0:05.3	The goal of Beyond Journal Club is to take landmark clinical trials and put them in a context,
0:09.6	telling the story of how we got to where we are and what it means for how we take care of patients.
0:13.6	Today we're going to talk about the use of steroids and the treatment of
0:16.8	community acquired pneumonia. I'm Dr. Sue Ellen Lee, an editorial fellow at the
0:20.7	New England Journal of Medicine in a hospitalist at MGH.
0:24.0	I'm Dr. Greg Katz, a cardiologist at NYU.
0:26.5	And I'm Dr. Klemley, a former fellow and current guest editor at the New England Journal of Medicine.
0:31.1	Today we're talking about the Cape Cod Trial, which was published in the New England Journal of Medicine. Today we're talking about the Cape Cod trial which was published in the New England Journal of Medicine in May of 2023.
0:37.0	The Cape Cod trial explored whether using glucocorticoids in the treatment of severe community qu pneumonia, or what we're going to call
0:43.4	CAP from now on, would reduce mortality. Thinking about this trial and talking to a
0:47.6	bunch of my colleagues who take care of lots of patients with pneumonia, the theme
0:51.3	that kept coming back is that interpreting a trial like this in the clinical
0:54.6	context and applying it to our patients is one of the most exciting and wonderful things about
0:58.6	being a doctor. Right, there's so much conflicting evidence. The history of steroids and pneumonia is like a
1:04.0	pendulum that swings back and forth between positive and negative trials. It's ultimately
1:08.6	up to you to decide whether the patient in front of you fits or doesn't fit into
1:12.4	table one.
1:13.6	And putting trials like Cape Cod into the context of the entirety of the body of research
1:18.2	that came before is not important just because of what it tells us about what
1:22.1	Cape Cod found, but also because applying
	...

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