Given dissociation between systemic and pulmonary anti-inflammatory effects of systemic CS and the established anti-inflammatory effects of inhaled CS in the alveolar compartment, inhaled CS are attractive candidates for adjuvant therapy in patients with pneumonia. Moreover, systematic CS have been associated with adverse effects, including hyperglycemia, increased rate of bleeding and secondary infections . Such side effects can be avoided or significantly minimized with the use of inhaled CS. There is a decent body of literature that supports, at the very least, clinical equipoise and dictates need for further trials.

But I think this study shows their benefit

In a double-blinded, multicenter feasibility trial by Festic et al., sixty patients at high risk for acute respiratory distress syndrome (ARDS) were randomized to receive an early 5-day course of inhaled budesonide and formoterol versus placebo (median time between presentation and treatment administration was less than 9 h). The primary outcome, oxygenation improvement, assessed by the ratio of pulse oxygen saturation to the fraction of inspired oxygen (S/F) was significantly improved in the treatment group. The improvement in oxygenation was limited to the subgroup of patients with pneumonia (N = 37, preplanned analysis). Results also showed that patients in the treatment arm had lower rates of mechanical ventilation (53% versus 21%, p = 0.01) and ARDS (23% vs. 0%, p = 0.01), and shorter hospital and ICU length of stays. There was an imbalance in shock between the two groups (14 (47%) in the placebo versus 4 (13%) in the treatment group); however, oxygenation improved in all patients with shock who received inhaled CS/BA compared to only 43% of those who had received placebo

[–] hotcouchguy@hexbear.net 2 points 1 week ago

I think I followed that, interesting to know