Is prednisone an effective treatment for bronchitis. What are the potential side effects of using prednisone for bronchitis. How does prednisone compare to other treatment options for bronchitis. What are the recommended dosages and duration of prednisone treatment for bronchitis.

Understanding Bronchitis: Symptoms and Causes

Bronchitis is a respiratory condition characterized by inflammation of the bronchial tubes, which are responsible for carrying air to and from the lungs. This inflammation can lead to a range of uncomfortable symptoms that can significantly impact a person’s quality of life.

Common Symptoms of Bronchitis

• Persistent cough, often with mucus
• Chest discomfort or tightness
• Shortness of breath
• Wheezing
• Fatigue
• Low-grade fever

Can bronchitis symptoms vary in severity. Absolutely. While some individuals may experience mild discomfort, others might find their daily activities significantly impaired by severe coughing fits and breathing difficulties.

Causes of Bronchitis

Bronchitis can be caused by various factors, including:

• Viral infections (most common cause)
• Bacterial infections (less common)
• Exposure to irritants (e.g., cigarette smoke, air pollution)
• Allergies

Do viral and bacterial bronchitis require different treatments. Indeed, they do. While viral bronchitis typically resolves on its own with supportive care, bacterial bronchitis may require antibiotic treatment.

The Role of Prednisone in Bronchitis Treatment

Prednisone, a corticosteroid medication, has long been used in the treatment of various inflammatory conditions, including bronchitis. Its primary function is to reduce inflammation in the airways, potentially alleviating symptoms such as coughing and breathing difficulties.

How Prednisone Works

Prednisone works by suppressing the immune system’s inflammatory response. In the case of bronchitis, this can help reduce swelling in the bronchial tubes, making it easier for air to pass through and potentially reducing the severity of symptoms.

Does prednisone directly combat the underlying cause of bronchitis. No, it doesn’t. Prednisone primarily addresses the symptoms by reducing inflammation, rather than targeting the viral or bacterial cause of the infection.

Effectiveness of Prednisone for Bronchitis: Recent Research Findings

Recent studies have shed new light on the effectiveness of prednisone in treating bronchitis, particularly in adults without asthma or chronic pulmonary diseases. A significant multicenter, placebo-controlled, randomized trial conducted in the United Kingdom has provided valuable insights into this topic.

Key Findings of the UK Study

• The study involved nearly 400 adults with acute lower respiratory tract infections
• Participants were divided into two groups: one receiving 40 mg/d of oral prednisolone for 5 days, and the other receiving a placebo
• The median cough duration was 5 days in both the prednisolone and placebo groups
• No significant differences were observed in symptom severity between the two groups
• The use of prednisone did not reduce the need for antibiotics or the occurrence of non-serious adverse events

What conclusions can we draw from this study. The research suggests that for adults without asthma or chronic pulmonary diseases, prednisone may not provide significant benefits in treating bronchitis symptoms.

Potential Side Effects and Risks of Prednisone Use

While prednisone can be effective in treating certain conditions, it’s important to be aware of its potential side effects and risks, especially when used for bronchitis treatment.

Common Side Effects of Prednisone

• Increased appetite and weight gain
• Mood changes, including irritability or anxiety
• Insomnia
• Fluid retention
• Increased blood sugar levels
• Weakened immune system

Are the side effects of prednisone dose-dependent. Generally, yes. Higher doses and longer durations of use are associated with an increased risk of side effects.

Long-term Risks of Prednisone Use

Prolonged use of prednisone can lead to more serious health issues, including:

• Osteoporosis
• Increased risk of infections
• Adrenal suppression
• Cataracts and glaucoma
• Skin thinning and easy bruising

Can these risks be mitigated. To some extent, yes. Healthcare providers often prescribe the lowest effective dose for the shortest duration possible to minimize potential risks.

Alternative Treatments for Bronchitis

Given the recent research findings and potential side effects of prednisone, it’s worth exploring alternative treatments for bronchitis. These options can be particularly valuable for individuals who may not benefit from or are unable to tolerate prednisone.

Over-the-Counter Medications

• Cough suppressants (e.g., dextromethorphan)
• Expectorants (e.g., guaifenesin)
• Pain relievers and fever reducers (e.g., acetaminophen, ibuprofen)

How do these medications differ from prednisone. Unlike prednisone, these medications target specific symptoms rather than addressing inflammation directly. They can provide relief without the potential systemic effects of corticosteroids.

Home Remedies and Lifestyle Changes

Several non-pharmaceutical approaches can help manage bronchitis symptoms:

• Staying hydrated to thin mucus secretions
• Using a humidifier to moisten the air
• Avoiding irritants such as smoke and strong odors
• Getting plenty of rest
• Practicing good hand hygiene to prevent spread of infection

Can these home remedies replace medical treatment. While they can provide significant relief, it’s important to consult with a healthcare provider, especially if symptoms persist or worsen.

When to Seek Medical Attention for Bronchitis

While many cases of bronchitis can be managed at home, there are situations where professional medical attention is necessary. Recognizing these signs can help ensure timely and appropriate treatment.

Warning Signs Requiring Medical Evaluation

• Persistent fever above 100.4°F (38°C) for more than three days
• Coughing up blood or rust-colored sputum
• Severe chest pain or difficulty breathing
• Symptoms lasting more than three weeks
• Recurrent episodes of bronchitis

Should individuals with pre-existing respiratory conditions be more vigilant. Absolutely. Those with conditions such as asthma, COPD, or a history of pneumonia should seek medical advice sooner if they develop bronchitis symptoms.

Diagnostic Procedures for Bronchitis

When you visit a healthcare provider for suspected bronchitis, they may perform several tests to confirm the diagnosis and rule out other conditions:

• Physical examination, including listening to your lungs
• Chest X-ray to rule out pneumonia
• Pulmonary function tests to assess lung capacity
• Sputum culture to identify the presence of bacteria

Are these tests always necessary for diagnosing bronchitis. Not always. In many cases, a healthcare provider can diagnose bronchitis based on symptoms and physical examination alone. Additional tests may be ordered if there are concerns about complications or underlying conditions.

Preventing Bronchitis: Strategies for Respiratory Health

While treatment options for bronchitis are important, prevention is always preferable. By adopting certain lifestyle habits and taking precautions, individuals can significantly reduce their risk of developing bronchitis.

Lifestyle Changes for Bronchitis Prevention

• Quit smoking and avoid secondhand smoke
• Practice good hand hygiene
• Stay up-to-date with vaccinations, including flu shots
• Maintain a healthy diet and exercise routine to boost immune function
• Manage stress levels effectively

How effective are these preventive measures. While they can’t guarantee complete protection, these strategies can significantly reduce the risk of developing bronchitis and other respiratory infections.

Environmental Considerations

The environment plays a crucial role in respiratory health. Consider the following measures to reduce exposure to irritants:

• Use air purifiers in your home, especially if you live in an area with high pollution levels
• Avoid outdoor activities during high pollution days
• Wear a mask when exposed to dust, fumes, or other airborne irritants
• Keep indoor humidity levels between 30-50% to discourage mold growth

Can environmental factors alone cause bronchitis. While they can certainly increase the risk, bronchitis is typically caused by viral or bacterial infections. However, environmental irritants can exacerbate symptoms and make individuals more susceptible to infections.

The Future of Bronchitis Treatment: Emerging Research and Therapies

As our understanding of respiratory health continues to evolve, researchers are exploring new avenues for bronchitis treatment and prevention. These emerging therapies and research directions hold promise for more effective management of bronchitis in the future.

Targeted Anti-inflammatory Therapies

Scientists are investigating more targeted anti-inflammatory medications that could provide the benefits of drugs like prednisone without the systemic side effects. These include:

• Inhaled corticosteroids with improved lung delivery systems
• Selective glucocorticoid receptor agonists (SEGRAs)
• Novel anti-inflammatory compounds targeting specific pathways in bronchial inflammation

Could these targeted therapies replace systemic corticosteroids like prednisone. While it’s too early to say definitively, they show promise in providing more localized anti-inflammatory effects with potentially fewer systemic side effects.

Immunomodulatory Approaches

Research is also focusing on ways to modulate the immune response to respiratory infections, potentially preventing or reducing the severity of bronchitis. Areas of investigation include:

• Development of new vaccines targeting common respiratory pathogens
• Exploration of probiotics and prebiotics to enhance respiratory immune function
• Investigation of natural compounds with immunomodulatory properties

How might these approaches change bronchitis treatment. By focusing on enhancing the body’s natural defenses, these strategies could potentially reduce the need for pharmaceutical interventions and provide more sustainable long-term protection against respiratory infections.

Personalized Medicine in Bronchitis Treatment

The field of personalized medicine is making strides in tailoring treatments to individual patients based on their genetic makeup, lifestyle factors, and specific type of bronchitis. This approach could lead to:

• More accurate predictions of which patients will respond to specific treatments
• Customized treatment plans based on an individual’s risk factors and biomarkers
• Development of targeted therapies for specific subtypes of bronchitis

Will personalized medicine revolutionize bronchitis treatment. While it’s still in its early stages, personalized medicine holds great potential for improving treatment outcomes and reducing unnecessary medication use in bronchitis patients.

Conclusion: Balancing Treatment Options for Bronchitis

As we’ve explored throughout this comprehensive guide, the treatment of bronchitis, particularly the use of prednisone, is a complex and evolving field. Recent research has challenged some long-held beliefs about the effectiveness of corticosteroids in treating bronchitis, especially in adults without underlying respiratory conditions.

The key takeaways from this exploration include:

• Prednisone may not be as effective for bronchitis treatment as previously thought, particularly in adults without asthma or chronic pulmonary diseases
• The potential side effects and risks of prednisone use should be carefully considered against its potential benefits
• Alternative treatments, including over-the-counter medications and home remedies, can provide effective symptom relief for many bronchitis patients
• Prevention strategies, including lifestyle changes and environmental considerations, play a crucial role in maintaining respiratory health
• Emerging research in targeted therapies, immunomodulation, and personalized medicine holds promise for improved bronchitis treatment in the future

Moving forward, what approach should individuals with bronchitis take? The most prudent course of action is to consult with a healthcare provider for personalized advice. They can assess your specific situation, considering factors such as the severity of your symptoms, your overall health status, and any underlying conditions, to determine the most appropriate treatment plan.

As our understanding of bronchitis and its treatment continues to evolve, staying informed about the latest research and treatment options is crucial. By combining this knowledge with professional medical advice, individuals can make informed decisions about their respiratory health and effectively manage bronchitis symptoms.

Remember, while bronchitis can be a challenging condition, with the right approach to treatment and prevention, most individuals can expect a full recovery and maintain good respiratory health in the long term.

Oral Prednisone Found to be Ineffective Against Bronchitis Symptoms

Aug 30, 2017

Contagion Editorial Staff

The results of a new study from the United Kingdom reveal that oral prednisone had no effect on the severity and duration of symptoms in adult patients suffering from bronchitis.

Bronchitis is a respiratory infection caused by inflammation of the pathways that carry air to an individual’s lungs, the bronchial tubes. Because the infection is usually caused by a virus, antibiotics should not be prescribed as treatment and instead, medications to help deal with the symptoms, such as Tylenol for pain or fever, are prescribed. Sometimes, doctors will also prescribe a steroid to help decrease the inflammation; however, the results of a new study have found that this may be both unnecessary and ineffective.

For the multicenter, placebo-controlled, randomized trial, published in the Journal of the American Medical Association, researchers from the University of Bristol in England, “tracked outcomes for nearly 400 adults with acute (short-term) lower respiratory tract infections,” according to a press release on the study. The trial was conducted in 54 family practices in England from July 2013 to October 2014 (month of final follow-up).

Half of the patients received 40 mg/d of oral prednisolone for 5 days, while the other half received a placebo, also for 5 days. None of patients suffered from asthma, or had a history of “chronic pulmonary disease or use of asthma medication in the past 5 years,” according to the study. In addition, none of the patients had a bacterial infection that would require antibiotics.

The results showed that, “Among the 398 patients with baseline data (mean age, 47 [SD, 16.0] years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range [IQR], 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = . 36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, −0.20; 95% CI, −0.40 to 0.00; P = .05 at an α = .001). No significant treatment effects were observed for duration or severity of other acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, or nonserious adverse events. There were no serious adverse events.”

Because there were no reductions in the severity or duration of cough or other symptoms as a result of the steroid (when compared with the placebo group), the authors do not recommend the use of steroids for treating the symptoms of bronchitis in patients without asthma. To this end, lead study researcher, Alastair Hay, MD, primary care professor at the University of Bristol, stated in the press release, “Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity. We would not recommend their use for this group of patients.”

Steroid medications can be used to successfully relieve asthma symptoms; and so, although he is heartened to hear that doctors have more evidence to support not prescribing steroids for these infections, Len Horovitz, MD, a pulmonary specialist at Lenox Hill Hospital in New York City, New York, stated in the press release, “In adults with asthma, any infection may cause a flare of asthma, and steroids might be indicated in this population of patients, depending on the severity of the asthma symptoms.”

How Prednisone Can Help Treat Bronchitis: A Comprehensive Guide

If you’ve been diagnosed with bronchitis, you may be wondering what treatment options are available to you. One medication that is commonly prescribed for bronchitis is prednisone. In this guide, we’ll explore how prednisone works, its potential side effects, and how it can help alleviate your bronchitis symptoms.

What is Prednisone?

Prednisone is a type of steroid medication that is used to reduce inflammation in the body. It is commonly prescribed for a variety of conditions, including asthma, arthritis, and autoimmune disorders. When used to treat bronchitis, prednisone works by reducing inflammation in the airways, which can help improve breathing and reduce coughing.

How is Prednisone Taken?

Prednisone is typically taken orally in the form of a tablet. The dosage and duration of treatment will depend on the severity of your bronchitis and other factors, such as your age and overall health. Your healthcare provider will provide specific instructions on how to take prednisone, including when to take it and how often.

What are the Potential Side Effects of Prednisone?

Like all medications, prednisone can cause side effects. Some of the most common side effects of prednisone include:

• Increased appetite
• Weight gain
• Mood changes
• Difficulty sleeping
• Increased risk of infection

It’s important to talk to your healthcare provider about any potential side effects of prednisone before starting treatment.

How Can Prednisone Help Alleviate Bronchitis Symptoms?

Prednisone can help alleviate bronchitis symptoms by reducing inflammation in the airways. This can help improve breathing and reduce coughing. However, it’s important to note that prednisone is not a cure for bronchitis. It is simply a treatment option that can help alleviate symptoms while your body fights off the infection.

When Should You Consider Taking Prednisone for Bronchitis?

If you have been diagnosed with bronchitis and are experiencing severe symptoms, such as difficulty breathing or a persistent cough, your healthcare provider may recommend prednisone as a treatment option. However, it’s important to note that prednisone is not always necessary for the treatment of bronchitis. In many cases, rest, hydration, and over-the-counter medications can help alleviate symptoms without the need for prescription medication.

Conclusion

Prednisone can be an effective treatment option for bronchitis, but it’s important to talk to your healthcare provider about whether it’s the right choice for you. If you’re experiencing severe bronchitis symptoms, book an appointment with Nao Medical today to receive personalized treatment and care.

Frequently Asked Questions

What is bronchitis?

Bronchitis is a respiratory condition that occurs when the bronchial tubes become inflamed. This can cause symptoms such as coughing, wheezing, and difficulty breathing.

How is bronchitis treated?

The treatment for bronchitis depends on the severity of the condition. In many cases, rest, hydration, and over-the-counter medications can help alleviate symptoms. However, in more severe cases, prescription medications such as prednisone may be necessary.

What are the potential side effects of prednisone?

Some of the most common side effects of prednisone include increased appetite, weight gain, mood changes, difficulty sleeping, and an increased risk of infection.

Is prednisone right for me?

Whether or not prednisone is right for you depends on a variety of factors, including the severity of your bronchitis and your overall health. Talk to your healthcare provider about whether prednisone is a good treatment option for you.

Learn more about pulmonology

Visit the American Lung Association website

Disclaimer: The information presented in this article is intended for general informational purposes only and should not be considered, construed or interpreted as legal or professional advice, guidance or opinion.

Prednisolone for bronchitis and bronchial asthma pulmono.ru

Prednisolone is a drug from the group of glucocorticoids, an analogue of hydrocortisone. Influences at the system level. It is prescribed for bronchial asthma and other diseases that require a rapid increase in the level of adrenal hormones in the blood.

The action of the drug in allergy and inflammation

It acts in the following ways:

1. Prevents the destruction of lysosome membranes and the release of proteolytic enzymes. Thus, when tissues are damaged, pro-inflammatory proteolytic enzymes remain in lysosomes.
2. Reduces vascular permeability, prevents the outflow of blood plasma into tissues. The drug prevents the development of edema .
3. Inhibits the migration of leukocytes to the focus of inflammation and phagocytosis of damaged cells.
4. Has an immunosuppressive effect, reducing the formation of lymphocytes and eosinophils. Large doses cause involution of lymphoid tissue.
5. Reduces fever by inhibiting the release of interleukin-1 from leukocytes, which activates the hypothalamic thermoregulatory center.
6. Suppresses the formation of antibodies.
7. Inhibits the interaction of foreign proteins with antibodies.
8. Inhibits the release of allergy mediators from basophils and mast cells.
9. Reduces the sensitivity of tissues to histamine and other biologically active substances that have a pro-inflammatory effect.
10. Suppresses the biosynthesis of prostaglandins, interleukin-1, tumor necrosis factor.
11. Reduces the viscosity of mucus in the bronchi.
12. Increases the affinity of beta-adrenergic receptors of the bronchial tree to catecholamines, resulting in increased blood pressure.

Prednisolone suppresses allergic reactions and inflammation.

Under its influence scarring of the connective tissue slows down. Glucocorticoids stimulate the formation of red blood cells in the red bone marrow. Their long-term use can cause polycythemia.

Influence on metabolism

At the systemic level, the drug affects the metabolism of carbohydrates, lipids and proteins. In liver cells, the number of enzymes necessary for the formation of glucose from amino acids and other substances increases. Due to the stimulation of gluconeogenesis in the liver, a store of glycogen is formed. The level of glucose in the blood rises, while the consumption of carbohydrates by cells decreases. An increase in blood sugar concentration triggers the synthesis of insulin by pancreatic cells. Tissue susceptibility to insulin decreases under the action of glucocorticoids.

Hormones of the adrenal cortex reduce the concentration of amino acids in all cells of the body, except for hepatocytes. At the same time, the level of globulin proteins and amino acids in the blood plasma increases, the level of albumins falls. In tissues, there is an intensive breakdown of proteins. The released amino acids go to the liver, where they are used to synthesize glucose.

Prednisolone stimulates lipid catabolism. The concentration of free fatty acids in the blood plasma increases, they are used as an energy source. The drug reduces the excretion of water and sodium from the body, increases the excretion of potassium . Reduces calcium absorption in the gastrointestinal tract and bone mineralization.

Long-term use of prednisolone reduces the synthesis of corticotropin by the adenohypophysis, resulting in a decrease in the formation of endogenous glucocorticoids by the adrenal cortex.

Formulations

Available as:

• 1 and 5 mg tablets,
• injection solution with active substance content 15 and 3 mg,
• ointments for external use,
• eye drops.

The drug has a systemic effect only when injected or orally. Injections can be either intravenous or intramuscular.

Prednisolone for bronchial asthma

When choosing a baseline drug, the doctor should take into account the severity of asthma and the presence of complications. The age and body weight of the patient also matters. Prednisolone is prescribed for severe forms of the disease, when inhaled corticosteroids do not have a therapeutic effect.

In the first days of treatment, it is recommended to take up to 60 mg of the drug per day, gradually reducing the dose of the drug . The duration of the course varies from 3 to 16 days. Cancellation of systemic glucocorticoids should be gradual in order to avoid the development of hypofunction of the adrenal cortex.

The optimal time for taking is in the morning, which is associated with the natural rhythms of the functioning of the endocrine system. Tablets should be drunk once a day, but when prescribing very large doses, fractional intake is possible. Some doctors believe that the maximum effect of Prednisolone is achieved with the introduction of the drug in the middle of the day. The maintenance dose of the medicine can be taken every other day.

Prednisolone in asthma is combined with β ₂ long-acting adrenomimetics, bronchodilators, non-steroidal anti-inflammatory drugs. To mitigate side effects, it is recommended to increase the intake of potassium from food or medicine while taking Prednisolone.

For other diseases of the respiratory system

Prednisolone is used not only for the treatment of bronchial asthma, but also for the following diseases of the respiratory system:

• acute alveolitis,
• sarcoidosis,
• tuberculosis,
• aspiration pneumonia,
• lung cancer,
• purulent tonsillitis,
• allergic bronchitis.

In cancer, Prednisolone supplements surgical removal of the tumor, cytostatics and radiation. For the treatment of tuberculosis, glucocorticoids are prescribed in conjunction with chemotherapy. With angina, the use of Prednisolone and other hormonal drugs is indicated only in combination with antibiotics. Glucocorticoids reduce inflammation and reduce fever, but do not suppress the activity of pathogenic microflora.

Prednisolone for bronchitis is used if the disease has an allergic etiology and is complicated by obstruction.

Contraindications

An absolute contraindication for taking the drug is an individual intolerance to the active substance or auxiliary components. With caution, the medicine is used for:

• pathologies of the gastrointestinal tract,
• viral, bacterial and fungal infections,
• parasitic diseases,
• immunodeficiencies;
• endocrine disorders;

Taking corticosteroids by a pregnant woman can cause hypofunction of the adrenal cortex and growth failure in the fetus. It is undesirable to use Prednisolone before and after vaccination, as the drug suppresses the immune response.

Side effects

Most common side effects during treatment:

• obesity with excess fat deposition on the face and in the cervical-collar zone,
• increased blood glucose,
• arterial hypertension,
• arrhythmias,
• bradycardia,

9 0009 thrombosis,

• disorders of the digestive system,
• neurosis;

Compared to other systemic hormonal drugs, Prednisolone has a weak mineralocorticoid effect and a mild effect on skeletal muscles.

Which drugs can be substituted

The following systemic glucocorticoids can be used in bronchial asthma:

• methylprednisolone,
• dexamethasone, nolon.

Despite the similarity of effects on the body, the listed drugs cannot be considered complete analogues. They differ in metabolic rate, the severity of the therapeutic effect and side effects.

Methylprednisolone and Prednisolone differ from other drugs in their faster excretion from the body. Methylprednisolone has a slight effect on appetite and psyche, and therefore is more often prescribed to patients with overweight and mental disorders.

Triamcinolone is a drug with an intermediate duration of action. It causes side effects on the skin and muscles, and therefore its long-term use is undesirable.

Dexamethasone and betamethasone are long acting drugs. Dexamethasone for asthma is prescribed if the patient suffers from a severe form of the disease, turning into status asthmaticus. The drug has a more pronounced glucocorticoid activity than prednisolone, but does not affect water and electrolyte metabolism.

Do systemic corticosteroids improve outcomes in exacerbations of chronic obstructive pulmonary disease?

Why is this question important?

Chronic obstructive pulmonary disease (COPD), also referred to as emphysema or chronic bronchitis, is a chronic lung disease commonly associated with smoking. People with COPD usually have persistent symptoms of shortness of breath and may experience intermittent flare-ups (flare-ups), often triggered by an infection, when symptoms become much worse and require further medical intervention beyond regular inhaler treatment.

Systemic (ie, non-inhaled corticosteroids) such as prednisolone, prednisone, and cortisone are anti-inflammatory drugs commonly used in the treatment of exacerbations. We wanted to evaluate the efficacy of systemic corticosteroids and to investigate whether different routes of administration could have an impact on the outcome of COPD exacerbations.

How did we answer this question?

We searched for all studies that compared corticosteroids given either by injection (parenteral) or tablets (oral) with matching placebo injections or tablets, and all studies that compared injectable corticosteroids with corticosteroids administered in the form of tablets.

What did we find?

We found 16 studies, including more than 1700 people with COPD who had exacerbations requiring additional medical treatment, that compared corticosteroids given as injections or tablets with placebo treatment. Four studies (about 300 people) compared corticosteroid injections with oral corticosteroids. More men than women took part in the studies, and they tended to be over 60 years of age with moderately severe symptoms of COPD. Most of the studies were in hospitals, two were in intensive care units with people who needed breathing support, and three included people who were treated at home. The last search for evidence was conducted in May 2014.

There were three studies in which people knew what treatment they were receiving, but otherwise the studies were generally well designed.

People treated with corticosteroids, either by injection or tablet, were less likely to experience treatment failure when compared with placebo: 122 fewer people per 1000 treated; they had a lower recurrence rate per month. They had a shorter length of stay in the hospital if assisted ventilation was not required in the intensive care unit, and their lung and respiratory functions improved faster during treatment. However, they had more side effects with treatment, especially temporary increases in blood glucose levels. Treatment with corticosteroids did not reduce the number of people who died within one month of the flare-up.

In studies comparing two routes of administration of corticosteroids, either by injection or by tablet, there were no differences in outcomes of treatment failure, hospital stay, or deaths after discharge. However, the transient increase in blood glucose levels was more likely to be due to injections than to tablets.

Output

There is high quality evidence, and is unlikely to be changed by future studies, that people with COPD exacerbations benefit from treatment with corticosteroid injections or tablets, with an increased risk of some temporary side effects.

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