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Avoid the ‘Roids – Steroids for Lower Respiratory Infection

September 19, 2017

Spoon Feed
Oral steroids were of no benefit for non-asthmatic patients with bronchitis.

Why does this matter?
There are few treatments that will relieve the coughing and discomfort of bronchitis, and often steroids are prescribed.  This RCT showed conclusively that this was of no help in patients without asthma.  Don’t forget, steroids are not benign.

Hold the ‘roids
This was a double-blinded RCT of 401 patients with lower respiratory tract infection symptoms and no history of asthma or COPD, treated at 54 family practice clinics in the UK with 40mg prednisolone or placebo daily for 5 days.  There was no difference in duration of cough or severity of symptoms between groups.  Most patients with acute bronchitis do not need antibiotics, and now we have firm evidence that they don’t benefit from steroids either.

Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection: A Randomized Clinical Trial.  JAMA. 2017 Aug 22;318(8):721-730. doi: 10.1001/jama.2017.10572.

Another Spoonful
EM Lit of Note considers this study practice changing – see his thoughts.

Peer reviewed by Thomas Davis, MD