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Effect of Dexamethasone on Mortality in Adult and Elderly Patients with Sepsis: a Systematic Review

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Abstract

Sepsis is a serious disease that affects many people worldwide, and many therapies are used, including corticosteroids such as dexamethasone. However, there is no conclusion as yet, concerning the use of dexamethasone in patients with sepsis or septic shock. The aim of this study was to perform a literature review to assess the mortality of patients with sepsis or septic shock using dexamethasone, answering the following question: What is the effect of dexamethasone on mortality in adult and elderly patients with sepsis compared with mortality in patients who do not use anti-inflammatory therapy? The protocol of this study was registered in the PROSPERO database. The systematic literature search was performed in four electronic databases. Bias risk assessments were performed using the Cochrane Collaboration tool, and notification quality was assessed using the CONSORT-based checklist. The literature search initially identified 13,999 records. The three selected studies included eighty adult patients with sepsis or septic shock who had received dexamethasone as an intervention. Of the three articles, two concluded that the use of dexamethasone significantly reduces the mortality in patients with sepsis or septic shock. The Cochrane Collaboration tool bias risk results showed that none of the studies was completely bias-free and through the CONSORT checklist, it was found that none of the studies met 50% or more of the applicable requirements. Thus, it is clear from this review that further randomized clinical trials comparing the use of dexamethasone to placebo in adjunctive therapy for sepsis patients are needed. The registration number in the PROSPERO database is CRD42018088150.

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Funding

This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil).

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Authors and Affiliations

  1. Postgraduation program in Pharmacy, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima Trindade, Florianópolis, SC, CEP 88040-900, Brazil

    Eduarda Fratoni, Marcus Vinicius Pereira dos Santos Nascimento, Eduarda Talita Bramorski Mohr & Eduardo Monguilhott Dalmarco

  2. Postgraduation program in Nutrition, Universidade Federal de Santa Catarina – UFSC, Florianópolis, SC, 88040-900, Brazil

    Ethiene da Silva Fontoura & Erasmo Benício Santos de Moraes Trindade

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  1. Eduarda Fratoni
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  2. Marcus Vinicius Pereira dos Santos Nascimento
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  3. Eduarda Talita Bramorski Mohr
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  4. Ethiene da Silva Fontoura
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  5. Erasmo Benício Santos de Moraes Trindade
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  6. Eduardo Monguilhott Dalmarco
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Correspondence to Eduardo Monguilhott Dalmarco.

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This systematic review did not require ethical approval.

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Fratoni, E., dos Santos Nascimento, M.V.P., Bramorski Mohr, E.T. et al. Effect of Dexamethasone on Mortality in Adult and Elderly Patients with Sepsis: a Systematic Review. SN Compr. Clin. Med. 2, 886–892 (2020). https://doi.org/10.1007/s42399-020-00334-9

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