A secondary analysis of a randomized trial showed that compared to placebo, prednisone therapy in a dose of 50 mg/day considerably reduced C-reactive protein levels, increased leukocyte and neutrophil counts, and had no effects on the levels of procalcitonin in patients with community-acquired pneumonia.

A study explored the effect of prednisone (a glucocorticoid) on the inflammatory biomarkers in a prior multicenter, randomized, placebo-controlled clinical trial that evaluated a seven-day therapy course of 50-mg prednisone to placebo in a large scale cohort of people hospitalized with community-acquired pneumonia. 

Using Wilcoxon tests and analysis of variance, the levels of C-reactive protein (CRP), procalcitonin, leukocyte and neutrophil count was estimated between people with and without glucocorticoid therapy at baseline and on days three, five, and seven and at discharge. Overall, 355 patient data sets in the placebo group and 356 in the prednisone group were available for assessment.

In comparison with placebo, the usage of prednisone was linked with a decline in the levels of CRP on days three, five, and seven (mean difference 46%). No such difference was noted for procalcitonin. At all the time points, the leukocyte and neutrophil counts were greater in the prednisone group (mean difference of 33% for neutrophils and 27% for leukocytes). 

Prednisone does not considerably influence procalcitonin levels. Hence, the levels of procalcitonin may be a more suitable and reliable parameter for therapy response in  pneumonia patients receiving prednisone and can better mirror the resolution of infection than the traditional inflammatory markers.