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.”

Steroids not effective for chest infections in adults who don’t have asthma or other chronic lung disease

Published: 22 August 2017

Steroids not effective for chest infections in adults who don’t have asthma

Oral steroids should not be used for treating acute lower respiratory tract infection (or ‘chest infections’) 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 new study published in the journal JAMA.

In the study, carried out by researchers at the Universities of Southampton, Bristol, Nottingham and Oxford, 398 non-asthmatic adults with acute chest infections − but no evidence of pneumonia and not requiring immediate antibiotic treatment − were randomly split into two groups, one receiving 40mg of the oral steroid ‘prednisolone’ for five days and one receiving a placebo over the same time period.

The team found there was no reduction in the duration of cough, the main symptom of chest infections, or the severity of the accompanying symptoms between two and four days after treatment (when symptoms are usually at their most severe) 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.

Professor Michael Moore, a study co-author from the University of Southampton, said: “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. 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.”

Professor Moore said that alternative methods of treating chest infections should be found to reduce the amount of antibiotics being used to combat anti-microbial resistance, which is considered a global health crisis. It does not look as if steroids are the answer, he said.

A recent study, led by the University of Southampton, showed that Andrographis Paniculata (A. Paniculata, Chuān Xīn Lián), a Chinese herbal medicine, appears beneficial and safe for relieving chest infections symptoms and results in a speedier recovery.

The systematic review, published in PLOS ONE, assessed data for 7,175 patients across 33 trials in six countries, which evaluated the effects of relieving chest infection symptoms, particularly cough and sore throat. It showed that A. Paniculata improved severity of cough and sore throat when compared with placebo and had a statistically significant effect in improving overall symptoms when compared to placebo, usual care, and other herbal therapies. Evidence also suggested that A. Paniculata (alone or plus usual care) shortened the duration of cough, sore throat and sick leave/time when compared to usual care.

Professor Moore said: “It is clear that most of the time antibiotics have very limited impact on the symptoms from chest infections, so the search is on to find alternative approaches to provide symptom relief.  Andrographis appears both safe and helpful in this area. More needs to be done to find alternative treatments to antibiotics if we are to get ahead of antibiotic resistance, which is increasing at an alarming rate. Herbal remedies could have a potential role to play.”

Bronchitis: symptoms, treatment, prevention – useful information

Find out everything you need to know about bronchitis – symptoms, treatment and prevention. On our website you will find useful tips and recommendations in order to avoid this disease and quickly recover if necessary.

Bronchitis is a common respiratory disease that causes inflammation of the bronchial tubes. It is characterized by cough, difficulty breathing, chest pain and other symptoms. It can be acute or chronic. The relevance of the topic is due to the fact that bronchitis can become complicated and develop into more serious health problems.

The purpose of this article is to provide comprehensive information about the symptoms, treatment and prevention of bronchitis. We will consider the causes of the disease, methods of diagnosis, effective methods of treatment and preventive measures to prevent recurrence of the disease. If you want to know more about bronchitis and its effects, then this article is for you.

At the end of the article you will find useful tips for those who have already suffered from bronchitis, as well as for those who are prone to respiratory diseases. We hope that this information will be useful and help you stay healthy and alert.

Bronchitis is a disease characterized by inflammation of the mucous membrane of the bronchi and leads to their narrowing.

Bronchitis is an inflammatory disease of the bronchial tubes that connect the trachea and lungs. It can have a different etiology: infectious, allergic, toxic, mechanical.

To establish an accurate diagnosis, it is necessary to examine the patient, analyze the symptoms and exclude other diseases of the upper and lower respiratory tract. Laboratory and instrumental studies may also be prescribed – blood for analysis, chest x-ray, bronchoscopy.

It is important to remember that if you have symptoms of bronchitis, you should consult a doctor who will prescribe the necessary treatment. Self-medication can worsen the condition and lead to complications.

The bronchi are air tubes that carry air to the lungs. When the bronchi become inflamed and irritated, it can lead to bronchitis. Bronchitis in the early stages may be a simple cold, but in a more serious form, it can become a chronic disease that requires more serious intervention.

The main symptoms of bronchitis are cough, which may worsen at night, weakness, fatigue and difficulty breathing. Some people may also experience chest pain and scant amounts of phlegm. As a rule, the symptoms worsen during the cold season, when it is cold and humid outside.

Q&A:

What are the symptoms of bronchitis?

The main symptoms of bronchitis include cough, sputum production, difficulty breathing, fever, headache and general weakness.

How quickly does bronchitis resolve?

The recovery time from bronchitis depends on its type and severity, but usually symptoms begin to decrease on the 3rd-4th day of treatment and full recovery takes about 2-3 weeks.

Should I take antibiotics for bronchitis?

If bronchitis is not caused by a bacterial but by a viral infection, then antibiotics are not indicated and may even worsen the condition. Also, you can not take antibiotics on your own without a doctor’s prescription.

Is it possible to treat bronchitis with folk remedies?

Folk remedies can help relieve symptoms and strengthen the immune system, but they cannot replace full medical treatment. Before using herbs and recipes, you should consult a specialist.

What measures can be taken to prevent bronchitis?

To prevent bronchitis, avoid contact with sick people, do not smoke, take regular strengthening procedures, maintain a healthy lifestyle and get vaccinated against infections if necessary.

What to do with chronic bronchitis?

People with chronic bronchitis need to maintain their health and manage symptoms, monitor indoor air quality, avoid contact with sources of infection, and consult with a specialist regularly to adjust treatment. Habits that promote lung health, such as exercise and proper breathing, are also needed.

Causes of Bronchitis

Bronchitis is a disease in which inflammation affects the bronchi and causes unpleasant symptoms such as coughing, shortness of breath and chest pain.

The main causes of bronchitis are infections, primarily viruses. Also, the risk of the disease increases with prolonged contact with toxic substances, such as cigarette smoke or chemical mechanisms at work. Separately, it is worth mentioning that susceptibility to bronchitis increases in people with immunodeficiency and allergic reactions, as well as in people suffering from respiratory diseases.

It is important to understand that bronchitis can take many forms and occur for various reasons. Therefore, in order to determine the correct treatment, it is necessary to accurately establish the diagnosis and identify the cause of the disease by seeking medical help.

The main recommendation for the prevention of bronchitis is to strengthen the immune system, create favorable conditions for the respiratory system and take care of your health in general.

• Emphasize proper nutrition rich in vitamins and microelements;
• Get regular exercise;
• Avoid contact with respiratory pathogens;
• Avoid smoking and exposure to polluted air;
• Maintain a healthy lifestyle, maintain respiratory hygiene and follow the advice of experts.

Treatment of bronchitis: what you need to know

Bronchitis is a disease that occurs when the bronchial tubes become inflamed. This is usually due to exposure to viruses or bacteria.

It is important to remember that the treatment of bronchitis should begin as early as possible. If you miss the onset of the disease, then in the future it can become chronic.

The main goal of treating bronchitis is to reduce inflammation, reduce coughing and make breathing easier. Several methods can be used to achieve this goal, including the use of drugs and natural remedies.

• Medicines commonly prescribed to treat bronchitis include antibiotics, anti-inflammatory drugs, mucolytics, and bronchodilators.
• Natural remedies such as herbs, honey, and lime tea can help relieve coughs and promote healing.

It is important to remember that self-treatment of bronchitis can be hazardous to health. The best choice is to consult a doctor and use only the medicines and methods recommended by him.

Diagnosis of bronchitis

Bronchitis is one of the most common diseases of the respiratory system. Diagnosis of this disease involves a number of medical procedures aimed at identifying the presence of inflammation in the bronchi and determining its characteristics.

• Physical examination is the first step in the diagnosis of bronchitis. The doctor examines the patient, reveals the presence of symptoms of the disease, such as cough, sputum production, shortness of breath and others.
• Lung exam – Your doctor may do lung tests, such as auscultation, which looks for breath sounds and lung murmurs. This method allows you to identify the presence of inflammation in the lungs and assess its degree.
• Sputum analysis – if the patient has a cough with sputum, then the doctor may refer him to sputum analysis. This analysis allows you to identify the presence and type of pathogenic microorganism that caused inflammation of the bronchi.
• Spirometry procedure – This procedure measures lung volume and ventilation rate. Spirometry is carried out using a special device – a spirometer.

Signs of bronchitis are not always characterized by vivid symptoms, so it is important to pay attention to any changes in the functioning of the respiratory system and consult a doctor in a timely manner to diagnose and treat the disease.

Treating bronchitis at home

Drink plenty of fluids

One of the important elements of treating bronchitis at home is to drink plenty of fluids. It helps to shed mucus that builds up in the airways and also moisturizes the mucous membranes of the lungs.

Applying heat

Heat can be helpful in treating bronchitis at home, especially if an early symptom is detected. Applying hot compresses, hot drinks, or hot baths raises core body temperature, stimulating the bronchial immune system and supporting blood flow.

Avoid smoking and polluted places

One of the main risk factors for developing bronchitis is smoking. People suffering from bronchitis should avoid smoking and places with polluted air.

Drink mixtures that fight bronchitis well

There are numerous mixtures that can improve bronchitis. Some of them include a mixture of eucalyptus oil or thyme oil with warm milk or a spoonful of honey. It is important to choose the right ingredient and follow the correct dosage.

Use of inhalers

Inhalers can be used to treat bronchitis at home. They can help in relieving coughs and improving breathing. It is important to check the correct use and follow the instructions.

Bronchitis medicines

Antibiotics

Antibiotics are medicines that fight the infection that causes bronchitis. They are usually prescribed only for a bacterial infection. Some of the most common antibiotics that may be used to treat bronchitis include azithromycin, amoxicillin, and clarithromycin. However, you should not self-medicate, only a doctor can choose the right drug treatment.

Bronchodilators

Bronchodilators are medicines that widen the airways, reduce bronchospasm and make breathing easier. These drugs are usually prescribed for obstructive bronchitis, such as obstructive bronchitis or asthmatic bronchitis. The best known bronchodilators are sympathomimetics such as salibutamol and fenoterol.

Glucocorticosteroids

Glucocorticosteroids are the standard treatment for anti-inflammatory bronchitis. These medicines are taken as inhalers and can help reduce inflammation in the lungs. Some examples of this type of drug include prednisolone, beclomethasone, and fluticasone.

Mucolytics

Mucolytics are medicines that help clear mucus from the lungs. They are used most often to treat bronchitis with viscous sputum. Some of the more common mucolytics include bromhexine, acetylcysteine, and carbocysteine.

Antitussives

Antitussives relieve coughing and may help reduce airway irritability. Although coughing is a common symptom of bronchitis, drugs are not always effective for some forms of bronchitis (for example, for obstructive bronchitis). Some common forms of antitussives that can be used for bronchitis are dextmethorphan and guaifenesin.

Non-ablative therapies

These are complementary therapies that are used to relieve the symptoms of bronchitis, but are not drugs. These include cold compresses on the chest, inhalations, squeezing of the legs, external application of warming ointments, chest massage.

Prevention of bronchitis: let’s protect ourselves in time

Basic principles of prevention of bronchitis

Prevention of bronchitis is one of the ways to fight the disease, which includes a set of measures. The main principles of prevention are:

• Maintain good hygiene
• Quit smoking and stay indoors with tobacco smoke
• Regularly ventilate and humidify the room
• Strengthen the immune system

The importance of proper nutrition and exercise

90 002 Getting enough vitamins and minerals through your diet and regular exercise will help keep your immune system strong. It is also important to monitor your health and consult a doctor on time if necessary.

Prevention of bronchitis in children

Particular attention should be paid to the prevention of bronchitis in children. Parents should ensure that the child does not become cold, avoid the child’s stay in rooms with a large number of people, and also take a course of vitamin therapy and immunization on time.

Prevention of bronchitis at home Prevention measure How to do it

Prevention of bronchitis

The main measure to prevent bronchitis is to maintain a healthy lifestyle. Regular physical activity strengthens the immune system and promotes more efficient lung function. It is also worth paying attention to proper nutrition, avoiding fatty and heavy foods.

It is very important to avoid contact with infected people, especially during the SARS epidemic. For prevention, it is recommended to regularly ventilate the room and wet cleaning to avoid air stagnation.

In the absence of contracts with infected people, but living in ecologically unfavorable areas or hazardous working conditions, special protective equipment should be used, such as masks or respirators.

• Do not smoke or drink alcohol, as this affects the functioning of the lungs.
• Perform manual hygiene and brush your teeth regularly to avoid infection of the nasopharynx and lungs with infectious diseases.
• Monitor pets to avoid contact with bronchitis pathogens such as bacteria and viruses.

It is also important to take care of your own health and treat respiratory diseases in a timely manner, in order to avoid complications such as chronic bronchitis.

Effect of stress on the development of bronchitis

Stress is one of the main causes of bronchitis. Under the influence of stress, the body releases hormones that increase the amount of mucus in the airways, which creates favorable conditions for the development of inflammatory processes.

Immunity is weakened in a stressful situation, which increases the likelihood of illness. A person begins to get sick often, and colds and flu can easily turn into bronchitis. This is especially dangerous for people with weakened immune systems, such as the elderly or people with chronic diseases.

Reducing the body’s adaptive capacity is another negative effect of stress that can lead to bronchitis. In conditions of lack of oxygen (for example, during acute bronchitis), the body must mobilize all its reserves in order to ensure proper breathing. However, with an increased level of stress in a person, this mechanism can be disrupted, which increases the risk of disease progression.

How to reduce the effect of stress on bronchitis:

• Try to remove from life the need to be constantly in tension and possible stressful situations, find time for rest and entertainment;
• Set a daily routine and keep it;
• A positive person who gets enough sleep and eats right is less prone to emotional breakdowns and illnesses.

Important to know!

Personal hygiene for the prevention of bronchitis

Bronchitis is a serious disease that causes inflammation of the bronchi and difficulty breathing. To protect your health, you must follow some rules of personal hygiene.

• Wash your hands regularly to avoid the spread of bacteria, viruses and infections.
• Do not touch your face with your hands – this can lead to the transfer of bacteria and other dangerous microorganisms into the body through the mucous membranes of the mouth and nose.
• Watch your teeth and gums – caries and other diseases of the oral cavity can cause bronchitis.
• Avoid smoking – even passive smoking can worsen the condition of the respiratory system and cause bronchitis.
• Wet clean indoors to avoid build-up of dust and allergens that can cause asthma and bronchitis.

Following these personal hygiene rules will help you not only avoid bronchitis, but also improve your overall health.

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 comparing corticosteroids given either by injection (parenteral) or tablets (oral) with matching placebo injections or tablets, and all studies comparing injectable corticosteroids with corticosteroids given as 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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