The paradoxical effect on pneumonia of chronic inhaled corticosteroids

Community-acquired pneumonia (CAP) is the leading infectious cause of death in developed countries. Several studies have shown that the risk of pneumonia is increased in patients with chronic obstructive pulmonary disease (COPD) who are receiving chronic inhaled corticosteroids (ICS). The impact of ICS on pneumonia prognosis is controversial. Recent studies have shown that COPD patients with prior ICS use have less mortality after developing CAP as compared with patients with COPD without prior ICS use. This review discusses the association of ICS and the risk of CAP and its association with clinical outcomes in patients with COPD and pneumonia.