Dexamethasone for Treating Severe Hospital-acquired Pneumonia in Critically Ill Patients With a Proinflammatory Phenotype

Exclusion Criteria

• •Pregnant women (serum or urine test), breastfeeding women.
• •Patient under legal protection (incl. under guardianship or trusteeship).
• •Hypersensitivity to dexamethasone and hypersensitivity to all of its excipients
• •Ongoing administration of glucocorticoid at the time of randomisation, such as for COVID-19 infection requiring supplemental oxygen therapy
• •Severe septic shock (norepinephrine \> 0.4 microg/kg/min and serum lactate level greater than 2 mmol/L) at the time of randomisation
• •Prolonged use of corticosteroids at a mean minimum dose of 0.3 mg/kg/day of prednisone equivalent for \>3 weeks in the past 60 days
• •Uncontrolled viral (hepatitis,herpes, zona, varicella) or systemic fungal infection
• •Immunosuppression pre-existing to hospitalisation (severe lymphopenia \< 500 lymphocytes/mm3, hematologic cancer, aplasia, chemotherapy/radiotherapy for cancer within 3 months prior to the inclusion, or anti-graft rejection drug).
• •Uncontrolled psychotic disorder (acute or chronical)
• •Patients not expected to survive for more than 48 hours.
• •Participation in another drug clinical trial :
• •* testing steroids or anti-graft rejection drug or chemotherapy- radiotherapy for cancer
• •* And / Or testing a drug regimen with a known interaction with dexamethasone,
• •* And / Or whose implementation would alter the HAP-DEX 6-month follow-up, notably the collection of the primary outcome.
• •* Situations that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study