Table 1

Summary of study characteristics

Trial (author, year)	Country	Study design	Industry funding	Severity score used for defining severe CAP	Number of patients			Type of corticosteroid	Corticosteroid dosing strategy	Timing of treatment initiation	Equivalent cumulative dose of dexamethasone *
Trial (author, year)	Country	Study design	Industry funding	Severity score used for defining severe CAP	Total	Control	Corticosteroid	Type of corticosteroid	Corticosteroid dosing strategy	Timing of treatment initiation	Equivalent cumulative dose of dexamethasone *
Marik et al34 1993	United States	Open-label	Not reported	BTS and ICU admission	30	16	14	Hydrocortisone	Hydrocortisone 10 mg/kg IV 30 min before antibiotics	30 mins prior to starting antibiotic therapy	28 mg
Confalonieri et al30 2005	Italy	Double-blinded, placebo-controlled	Not reported	ATS 1993, and ICU or RICU admission	46	23	23	Hydrocortisone	Hydrocortisone 200 mg IV bolus followed by 10 mg/h IV for 7 days	Not reported	75 mg
El Ghamrawy et al35 2006	Saudi Arabia	Double-blinded, placebo-controlled	Not reported	ATS 2001	34	17	17	Hydrocortisone	Hydrocortisone 200 mg IV bolus followed by 10 mg/h for 7 days	Not reported	75 mg
Snijders et al31 2010	The Netherlands	Double-blinded, placebo-controlled	No	CURB-65>2 or PSI class IV-V	93	45	48	Prednisolone	Prednisolone 40 mg IV or orally for 7 days	Not reported	42 mg
Sabry et al36 2011	Egypt	Double-blinded, placebo-controlled	No	ATS 2007	80	40	40	Hydrocortisone	Hydrocortisone 200 mg IV bolus, followed by hydrocortisone 12.5 mg/h IV for 7 days	Not reported	92 mg
Fernández-Serrano et al32 2011	Spain	Double-blinded, placebo-controlled	No	Respiratory failure (PaO₂/FiO₂<300)	45	22	23	Methylprednisolone	Methylprednisolone 200 mg IV bolus, followed by tapering infusion (20 mg/6 hour for 3 days, 20 mg/12 hours for 3 days, and 20 mg/day for 3 days) over 9 days	30 min before starting the antibiotic treatment	117 mg
Torres et al33 2015	Spain	Double-blinded, placebo-controlled	No	Modified ATS criteria or PSI V	120	59	61	Methylprednisolone	Methylprednisolone 0.5 mg/kg IV twice daily for 5 days	Within 36 hours of hospital admission	70 mg
Wittermans et al7 2021	The Netherlands	Double-blinded, placebo-controlled	Yes	PSI IV-V	156	79	77	Dexamethasone	Dexamethasone 6 mg oral daily for 4 days	Within 24 hours of emergency department presentation	24 mg
Meduri et al6 2022	United States	Double-blinded, placebo-controlled	No	Modified ATS/IDSA criteria, and ICU or intermediate admission	563	277	286	Methylprednisolone	Methylprednisolone 40 mg bolus followed by methylprednisolone 40 mg daily on days 1–7, 20 mg daily on days 8–14, 12 mg daily on days 15–17 and 4 mg daily on days 18–20.	On the day of randomisation	96 mg
Dequin et al8 2023	France	Double-blinded, placebo-controlled	No	Initiation of MV, initiation of high-flow nasal canula, PaO₂:FiO₂ ratio<300, or PSI V	795	395	400	Hydrocortisone	Hydrocortisone 200 mg IV daily for 4 days. A total of 8 or 14 days of hydrocortisone course determined by predefined clinical criteria. 200 mg IV hydrocortisone daily on day 1–7, 100 mg daily on day 8–11 and 50 mg daily on day 12–14 in 14 days treatment. 200 mg IV hydrocortisone daily on day 1–4, 100 mg daily on day 5–6 and 50 mg daily on day 7–8 in 8 days treatment.	Within 24 hours of onset of any severity criterion: requirement of mechanical ventilation, high flow nasal cannula with PaO₂:FiO₂<300 and FiO2>50%, or nonbreathing mask with PaO₂:FiO₂<300 and FiO2>50%, PSI index score>130	44 mg or 78 mg

*Corticosteroid converted to dexamethasone equivalent dose for 70 kg adult. Note that the conversion factors were as follows: dexamethasone:hydrocortisone 1:25; dexamethasone: prednisolone 1:6.7; dexamethasone:methylprednisolone 1:5.3. Equivalent cumulative dose of dexamethasone was rounded off to the nearest whole number.
ATS, American Thoracic Society; BTS, British Thoracic Society; CORB, Confusion, Oxygenation, Respiratory rate, Blood pressure; CURB-65, Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, and age 65 or older; FiO₂, fraction of inspired oxygen; ICU, intensive care unit; IDSA, Infectious Disease Society of America; IV, intravenous; MV, mechanical ventilation; PaO₂, arterial blood oxygen pressure; PEEP, positive end expiratory pressure; PSI, Pneumonia Severity Index; RICU, respiratory intensive care unit.