From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Inhaled corticosteroids are not recommended as a primary treatment for tracheitis, as they do not address the underlying bacterial cause of the condition and may potentially mask symptoms or delay appropriate treatment. Tracheitis is typically caused by bacterial infections, most commonly Staphylococcus aureus, and requires systemic antibiotics as the mainstay of treatment. For bacterial tracheitis, appropriate antibiotics such as cefuroxime, vancomycin, or clindamycin are typically used, depending on local resistance patterns and severity, as noted in various studies 1, 2, 3, 4, 5.
Key Considerations
- The use of inhaled corticosteroids in tracheitis may not be beneficial and could potentially lead to delayed diagnosis and treatment of the underlying bacterial infection.
- Systemic antibiotics are the primary treatment for bacterial tracheitis, and their selection should be based on local resistance patterns and the severity of the infection.
- Inhaled corticosteroids, such as budesonide, may be useful in reducing airway inflammation in certain respiratory conditions, but their use in tracheitis is not supported by the available evidence 3, 5.
Treatment Approach
- For bacterial tracheitis, treatment with systemic antibiotics such as cefuroxime (50-100 mg/kg/day divided every 8 hours), vancomycin (40-60 mg/kg/day divided every 6-8 hours), or clindamycin (30-40 mg/kg/day divided every 6-8 hours) is recommended, with treatment duration usually lasting 7-10 days.
- In severe cases, patients may require airway management, including intubation and mechanical ventilation.
- Viral tracheitis may be treated supportively, but bacterial tracheitis represents a medical emergency requiring prompt antibiotic therapy, as highlighted by the need for immediate medical attention in cases of suspected tracheitis, especially in children presenting with high fever, stridor, and respiratory distress 1, 2, 4.
Evidence Summary
The available evidence from studies 1, 2, 3, 4, 5 suggests that inhaled corticosteroids are not a recommended primary treatment for tracheitis, and that systemic antibiotics should be used as the mainstay of treatment for bacterial tracheitis. The most recent and highest quality study 5 provides insight into the properties of inhaled corticosteroids, but does not support their use in tracheitis.