Steroids Not Effective for Chest Infections in Adults Without Asthma

August 22, 2017

BRISTOL, United Kingdom -- August 22, 2017 -- Oral steroids should not be used for treating acute lower respiratory tract infection in adults who don’t have asthma or other chronic lung disease, as they do not reduce the duration or severity of symptoms, according to a study published in the August 22 issue of JAMA.

In the study, 398 adults without asthma with acute chest infections but no evidence of pneumonia and not requiring immediate antibiotic treatment were randomised to receive prednisolone 40 mg for 5 days (n = 198) or placebo (n = 200).

Results showed no reduction in the duration of cough or the severity of the accompanying symptoms between 2 and 4 days after treatment in the prednisolone group compared with the placebo group. The results suggest that steroids are not effective in the treatment of chest infections in non-asthmatic adult patients.

“Chest infections are one of the most common problems in primary care and often treated inappropriately with antibiotics,” said lead author Alastair Hay, MD, Bristol Medical School, the University of Bristol, Bristol, United Kingdom. “Corticosteroids, like prednisolone, are increasingly being used to try to reduce the symptoms of chest infections, but without sufficient evidence.”

“Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity,” he said. “We would not recommend their use for this group of patients.”

“Oral and inhaled steroids are known to be highly effective in treating acute asthma as well as infective flares of other long-term lung conditions but need to be used carefully because of the risk of unwanted side effects,” Mike Moore, University of Southampton, Southampton, United Kingdom. “We chose to test the effect of steroids for chest infections as some of the symptoms of chest infections, such as shortness of breath, wheeze, and cough with phlegm, overlap with acute asthma. However, we have conclusively demonstrated they are not effective in this group of patients.”

SOURCE: University of Bristol

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