Oral Versus Intravenous Dexamethasone

Inclusion criteria

• Aged 18 years and older
• Presenting to the emergency room with suspected pneumonia (to be confirmed within 24 hours from admission) Pneumonia is defined as a new or progressive infiltrate on a chest X-ray plus at least two of the following criteria: cough, sputum production, temperature >38°C or <35°C, auscultatory findings consistent with pneumonia, leucocytosis or leucopenia (>10 g/l, <4 g/l or >10% rods in leucocyte differentiation), C-reactive protein >3 times the upper normal limit Corticosteroid naive at time of presentation

Exclusion criteria

• Patients needing corticosteroid treatment above study medication
• Failure to obtain written consent to participate
• Patients using medication drugs that interact with dexamethasone (i.e. phenytoin, barbiturates, rifampicin, erythromycin, clarithromycin, aprepitant, colchicine, everolimus, itraconazole, ketoconazole, pazopanib, tipranavir, and vinorelbine)
• Moribund patients (defined as expected to die within 24 hours)
• Patients with proven or suspected allergy to dexamethasone
• Patients not capable of taking tablets orally