Background: Inhaled corticosteroid (ICS) is known to be associated with higher risk of pneumonia compared to long-acting bronchodilators in chronic obstructive pulmonary disease (COPD). However, clinical implication of ICS has not been sufficiently verified whether to affect prognosis of pneumonia.

Aims and objectives: To examine the clinical implication for pneumonia following ICS use as compared to non-ICS. 

Methods: Electronic health record of patients hospitalized for pneumonia underlying COPD were retrospectively reviewed. Pneumonia was confirmed either by chest radiography or computed tomography. Clinical outcomes of pneumonia in patients with COPD who received ICS and patients with COPD who received long-acting bronchodilators except ICS were compared each other.

Results: A total of 85 patients met enrollment criteria among 255 hospitalized patients. Patient numbers of ICS use and non-ICS use were 44 and 41, respectively. Mean age was 73.8 years in ICS use and 74.9 years in non-ICS use. Severity of COPD based on spirometry was not different. CURB-65 score at initial presentation of pneumonia was comparable between two groups. Proportions of multilobar infiltration, pleural effusion, and complicated pneumonia in radiologic studies were not different. Additionally, incidence of mechanical ventilation, mortality rate at 90 days, and length of hospital stay were not significantly different between two groups.   

Conclusions: The clinical outcomes of pneumonia following ICS in patients with COPD were not different compared to patients treated with non-ICS. ICS might not contribute to the severity and outcomes of pneumonia in COPD.