11/15/2025
Systemic corticosteroids are recommended for severe CAP based on trials like CAPE-COD and supporting meta-analyses. However, the REMAP-CAP trial found no mortality benefit—and possible harm—from hydrocortisone, raising concerns. Despite this, a Bayesian meta-analysis still supports corticosteroid use in high-risk ICU patients. Clinical decisions should consider disease severity, etiology, and individual patient factors.