Abstract：
Inflammatory response to aggressive infection is responsible not only for symptoms, especially pain, but also for severity, when the inflammatory cascade is violent, and provokes a deleterious cytokine storm. Due to their anti-inflammatory properties, corticosteroids are widely used in ambulatory medical practice. While their beneficial effects on some symptoms, particularly pain, are undeniable, so are the risks associated with their other properties (immunosuppression, neurostimulation, hypermetabolism), even during short-term administration at low doses. Following robust risk-benefit assessment, the role of corticosteroids in the treatment of a number of serious pathologies (septic shock, severe acute community-acquired pneumonia, and some forms of bacterial meningitis such as hypoxia-related pneumocystosis, etc.) is presently well-defined. The objective of this review is not to consider the role of corticosteroids in cases of severe infectious disease necessitating hospital-based management, or in contexts where there exists a clear consensus in favor of their utilization. This work represents an attempt to apprise the current state of knowledge on the interest of corticosteroids in the management of infections in adults in primary care. Corticosteroid treatment can be beneficial with regard to some of the infectious diseases treated in primary care. That said, when the benefit actually appears, it remains modest, and the level of evidence supporting the utilization of corticosteroids is low or moderate. In no situation is an indication for corticosteroid therapy official or even, at the very least, indisputable. With regard to the pathologies under consideration, corticosteroid prescription must imperatively be based on impeccable characterization of the clinical situation, diagnosis of severity, knowledge of the disease field, and risk-benefit assessment for a given patient.
摘要：
对侵袭性感染的炎症反应不仅是症状的原因，尤其是疼痛,但也是为了严重性，当炎症级联剧烈时，并引发有害的细胞因子风暴。由于它们的抗炎特性，皮质类固醇广泛用于门诊医疗实践。虽然它们对某些症状有有益的影响，尤其是疼痛,不可否认，与它们的其他特性相关的风险也是如此(免疫抑制，神经刺激,高代谢)，即使在低剂量的短期给药期间。在稳健的风险收益评估之后，皮质类固醇在治疗许多严重病变中的作用（感染性休克，严重急性社区获得性肺炎,和某些形式的细菌性脑膜炎，如缺氧相关的肺孢子虫病，等。)目前定义良好。本综述的目的不是考虑皮质类固醇在需要医院管理的严重传染病病例中的作用。或者在有明确共识支持使用它们的情况下。这项工作代表了一种尝试，旨在了解有关皮质类固醇在初级保健成人感染管理中的兴趣的当前知识状态。皮质类固醇治疗对于初级保健中治疗的一些传染病可能是有益的。那就是说,当好处真正出现时，它仍然谦虚，支持使用皮质类固醇的证据水平低或中等。在任何情况下都没有官方或什至是皮质类固醇治疗的适应症，至少,无可争辩。关于正在考虑的病症，皮质类固醇处方必须基于无可挑剔的临床表现，严重程度的诊断，疾病领域的知识，和给定患者的风险收益评估。
