Oral steroids for acute bronchitis

Oral corticosteroids, including prednisolone or prednisone, are powerful anti-inflammatory medications. They have some benefit for reducing pain in the first 2 weeks or so of an attack, when used with acyclovir or another nucleoside analogue. (They are not recommended without a nucleoside analogue.) They also may be helpful for improving symptoms of Bell's palsy and Ramsay Hunt syndrome. Corticosteroids do not appear to prevent a further shingles attack or reduce the risk for PHN. Side effects of corticosteroids can be severe, and patients should take oral steroids at as low a dose, and for as short a time, as possible. (Injected or intravenous steroids, however, may offer specific relief for PHN without significant side effects.)

The National Heart, Lung, and Blood Institute (NHLBI) recommended dosing for systemic prednisone, prednisolone, or methylprednisolone in pediatric patients whose asthma is uncontrolled by inhaled corticosteroids and long-acting bronchodilators is 1–2 mg/kg/day in single or divided doses. It is further recommended that short course, or "burst" therapy, be continued until the patient achieves a peak expiratory flow rate of 80% of his or her personal best or until symptoms resolve. This usually requires 3 to 10 days of treatment, although it can take longer. There is no evidence that tapering the dose after improvement will prevent a relapse.

Dr. Fine is presently associate professor of clinical dentistry and postdoctoral director of the Division of Periodontics at the School of Dental and Oral Surgery of Columbia University and associate attending dental surgeon on the Presbyterian Hospital Dental Service. He is a diplomate of the American Board of Periodontology. Dr. Fine has served on the Research, Science, and Therapy Committee of the American Academy of Periodontology, and has been the recipient of several teaching awards and fellowships. He has authored or coauthored numerous articles in the periodontal literature, and was an author of the text, Clinical Guide to Periodontics . He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. .

Observed baseline and 3-week mean ODI scores were and for the prednisone group and and for the placebo group, respectively. The prednisone-treated group showed an adjusted mean -point (95% CI, -; P = .006) greater improvement in ODI scores at 3 weeks than the placebo group and a mean -point (95% CI, -; P = .005) greater improvement at 52 weeks. Compared with the placebo group, the prednisone group showed an adjusted mean -point (95% CI, - to ; P = .34) greater reduction in pain at 3 weeks and a mean -point (95% CI, - to ; P = .15) greater reduction at 52 weeks. The prednisone group showed an adjusted mean -point (95% CI, -; P = .001) greater improvement in the SF-36 PCS score at 3 weeks, no difference in the SF-36 PCS score at 52 weeks (mean, ; 95% CI, - to ; P = .08), no change in the SF-36 MCS score at 3 weeks (mean, ; 95% CI, - to ; P = .10), and an adjusted -point (95% CI, -; P = .02) greater improvement in the SF-36 MCS score at 52 weeks. There were no differences in surgery rates at 52-week follow-up. Having 1 or more adverse events at 3-week follow-up was more common in the prednisone group than in the placebo group (% vs %; P < .001).

Oral steroids for acute bronchitis

oral steroids for acute bronchitis

Observed baseline and 3-week mean ODI scores were and for the prednisone group and and for the placebo group, respectively. The prednisone-treated group showed an adjusted mean -point (95% CI, -; P = .006) greater improvement in ODI scores at 3 weeks than the placebo group and a mean -point (95% CI, -; P = .005) greater improvement at 52 weeks. Compared with the placebo group, the prednisone group showed an adjusted mean -point (95% CI, - to ; P = .34) greater reduction in pain at 3 weeks and a mean -point (95% CI, - to ; P = .15) greater reduction at 52 weeks. The prednisone group showed an adjusted mean -point (95% CI, -; P = .001) greater improvement in the SF-36 PCS score at 3 weeks, no difference in the SF-36 PCS score at 52 weeks (mean, ; 95% CI, - to ; P = .08), no change in the SF-36 MCS score at 3 weeks (mean, ; 95% CI, - to ; P = .10), and an adjusted -point (95% CI, -; P = .02) greater improvement in the SF-36 MCS score at 52 weeks. There were no differences in surgery rates at 52-week follow-up. Having 1 or more adverse events at 3-week follow-up was more common in the prednisone group than in the placebo group (% vs %; P < .001).

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