From the Research
Steroids like prednisolone are generally not recommended for routine management of hand, foot, and mouth disease (HFMD). HFMD is typically a self-limiting viral illness that resolves within 7-10 days without specific treatment. Management should focus on supportive care including adequate hydration, fever control with acetaminophen or ibuprofen, and pain relief for mouth sores using topical oral anesthetics or analgesics.
Key Points to Consider
- While some clinicians have used steroids in severe cases with complications such as encephalitis, myocarditis, or pulmonary edema, there is insufficient evidence supporting their routine use for uncomplicated HFMD, as noted in a study from 1.
- Steroids may potentially worsen viral infections by suppressing the immune response and could lead to adverse effects including increased blood glucose, mood changes, and increased susceptibility to other infections.
- The cornerstone of HFMD management remains supportive care, with emphasis on preventing dehydration in children who may refuse to eat or drink due to painful mouth ulcers.
- Parents should be advised to seek medical attention if their child shows signs of dehydration, persistent high fever, unusual drowsiness, or severe symptoms.
Recent Evidence
A recent study from 2 highlights the changing epidemiology of HFMD causative agents, which is crucial for developing effective prevention and control strategies. However, this does not directly impact the use of steroids in HFMD management.
Clinical Considerations
In clinical practice, the use of steroids should be cautious and based on the severity of the disease and the presence of complications. As stated in 3, treatment is mainly symptomatic and supportive, with no specific antiviral agents approved for the treatment of the disease.