Severe Acute Respiratory Syndrome (SARS) Medication

Updated: Mar 13, 2019
  • Author: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Medication Summary

Currently, no definitive medication protocol specific to SARS has been developed, although various treatment regimens have been tried without proven success. [11, 12] The CDC recommends that patients suspected of or confirmed as having SARS receive the same treatment they would be administered if they had any serious, community-acquired pneumonia.

Because SARS is a viral infection, antibiotics are not indicated. In some of the early cases, antibiotics were administered as part of the treatment regimen, but no positive effect was noted.



Class Summary

Various steroid regimens have been used around the world as part of the initial SARS treatment cocktail. In the initial Hong Kong cohort of patients, corticosteroids were first given (with ribavirin) because of the similarity of the clinical and radiographic findings of SARS to those of bronchiolitis obliterans-organizing pneumonia. Despite anecdotal reports of success, the efficacy of steroids has not been confirmed in a clinical trial. [59, 60]

During phase 2 of the clinical course, intravenous (IV) administration of steroids has been shown to suppress cytokine-induced lung injury. It was also associated with favorable clinical improvement, with resolution of fever and lung opacities within 2 weeks. [60, 61]

However, a retrospective analysis showed an increased risk of 30-day mortality. Carefully designed studies will be needed to clarify the optimal role systemic steroids in the treatment SARS. Findings show that local pulmonary inflammation may be reduced with systemic glucocorticoid therapy.

Hydrocortisone (Cortef, A-Hydrocort, Solu-Cortef)

Hydrocortisone may be beneficial because of its mineralocorticoid activity and glucocorticoid effects.