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Oral Corticosteroids No Benefit for LRI in Non-Asthmatic Adults

TUESDAY, Aug. 22, 2017 -- For adults without asthma, with acute cough and at least one lower respiratory tract symptom, prednisolone does not reduce cough duration or severity, according to a study published in the Aug. 22/29 issue of the Journal of the American Medical Association.

Alastair D. Hay, M.B.Ch.B., M.D., 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 one lower respiratory tract symptom. Participants were randomized to two 20-mg prednisolone tablets (199 patients) or matched placebo (202 patients) once daily for five days.

Baseline data were available for 398 patients. The researchers found that the median duration of cough was five days in both the prednisolone and placebo groups (adjusted hazard ratio, 1.11; 95 percent confidence interval, 0.89 to 1.39; P = 0.36). The mean symptom severity was 1.99 and 2.16 points in the prednisolone and placebo groups, respectively (adjusted difference, −0.20; 95 percent confidence interval, −0.40 to 0.00; P = 0.05). 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.

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Posted: August 2017