Prednisolone Inefficient in Reducing Lower Respiratory Tract Infection Symptoms

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Researchers say adults without asthma should not be treated with oral corticosteroids because they do not reduce symptom duration or severity of lower respiratory tract infections.
Researchers say adults without asthma should not be treated with oral corticosteroids because they do not reduce symptom duration or severity of lower respiratory tract infections.

HealthDay News — For adults without asthma, with acute cough and at least 1 lower respiratory tract symptom, prednisolone does not reduce cough duration or severity, according to a study published in the Journal of the American Medical Association.

Alastair D. Hay, MBChB, MD, from the University of Bristol in the United Kingdom, and colleagues conducted a randomized trial in 54 family practices in England involving 401 patients with acute cough and at least 1 lower respiratory tract symptom.

Participants were randomized to 2 20-mg prednisolone tablets (199 patients) or matched placebo (202 patients) once daily for 5 days.

Baseline data were available for 398 patients. The researchers found that the median duration of cough was 5 days in both the prednisolone and placebo groups (adjusted hazard ratio, 1.11; 95% CI, .89 to 1.39; P =.36). The mean symptom severity was 1.99 and 2.16 points in the prednisolone and placebo groups, respectively (adjusted difference, −.20; 95% CI, −.40 to .00; P = .05).

There were no significant treatment effects for duration or severity of other lower respiratory infection symptoms, duration of abnormal peak flow, antibiotic use, or non-serious adverse events. No serious adverse events occurred.

"Oral corticosteroids should not be used for acute lower respiratory tract infection symptoms in adults without asthma because they do not reduce symptom duration or severity," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Reference

Hay AD, Little P, Harnden A, et al. Effect of oral prednisolone on symptom duration and severity in nonasthmatic adults with acute lower respiratory tract infection: a randomized clinical trial. JAMA. 2017; 318(8):721-730. 

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