From the Guidelines
Steroids are generally not recommended for treating typical upper respiratory infections (URIs). Most URIs are caused by viruses and will resolve on their own within 7-10 days with supportive care such as rest, hydration, and over-the-counter medications for symptom relief. Corticosteroids like prednisone or dexamethasone don't effectively treat the underlying viral cause and may potentially suppress the immune system, which could be counterproductive when fighting an infection.
Key Points to Consider
- In specific cases, such as severe asthma exacerbations triggered by a URI or significant allergic components, a healthcare provider might prescribe a short course of steroids, but this is not standard treatment for uncomplicated URIs.
- Instead, focus on symptom management with acetaminophen or ibuprofen for pain and fever, saline nasal sprays for congestion, and throat lozenges for sore throat.
- If symptoms persist beyond 10-14 days, worsen significantly, or if you develop high fever, severe headache, or difficulty breathing, consult a healthcare provider as these may indicate a bacterial infection or complications that might require different treatment approaches.
Evidence-Based Recommendations
According to the most recent and highest quality study 1, intranasal corticosteroids may have a modest benefit in treating acute bacterial rhinosinusitis (ABRS), but the evidence for systemic steroids is limited and suggests no benefit over placebo when used as monotherapy.
Important Considerations
- The American College of Physicians and the Centers for Disease Control and Prevention recommend reserving antibiotic treatment for patients with persistent symptoms or severe symptoms, and suggest using adjunctive therapies such as intranasal saline irrigation or intranasal corticosteroids to alleviate symptoms and potentially decrease antibiotic use 1.
- The use of steroids should be weighed against the associated cost and minor adverse events, and clinicians should rely on clinical experience and judgment when making treatment decisions 1.
From the Research
Steroids for Upper Respiratory Infection (URI)
- The use of steroids for treating upper respiratory infections (URIs) is a topic of discussion among medical professionals, with some studies suggesting their effectiveness in specific cases 2, 3.
- According to a study published in the Indian Journal of Pediatrics, corticosteroids have a proven beneficial role in certain pulmonary conditions, including asthma and croup 2.
- Another study published in Paediatrics & Child Health found that dexamethasone is highly efficacious in treating croup symptoms, which are often associated with upper respiratory infections 3.
- However, the use of steroids for other types of upper respiratory infections, such as acute respiratory distress syndrome (ARDS), is not recommended due to lack of evidence 4.
- Topical corticosteroids, such as nasal sprays, may be effective in treating allergic rhinitis, a common symptom of upper respiratory infections, but should be used with caution and under medical supervision 5.
- A recent study published in Health Technology Assessment found that daily low-dose prednisolone did not reduce the risk of relapse of steroid-sensitive nephrotic syndrome in children with upper respiratory tract infections, but may have economic benefits 6.