This large multicentre, double-blind randomised controlled trial assessed adjunctive corticosteroid therapy in HIV-negative immunocompromised patients with severe Pneumocystis jirovecii pneumonia (PJP) causing acute respiratory failure.
Adjunctive corticosteroid treatment showed a 10.9% absolute reduction in 28-day mortality (32.4% vs 21.5%) compared to placebo, but this difference was not statistically significant (p=0.069).
No significant differences were observed in secondary infections or insulin requirement, suggesting corticosteroid safety in this population.
These findings contrast with established benefits of corticosteroids in HIV-positive PJP, highlighting a need for further research in specific HIV-negative subgroups.
