From the Research
Effectiveness of Corticosteroid Therapy in Influenza Treatment
- The use of corticosteroids as adjunctive therapy in the treatment of influenza is controversial, with some studies suggesting potential benefits and others indicating harm 1, 2, 3, 4, 5.
- A systematic review and meta-analysis found that corticosteroid treatment was significantly associated with mortality and nosocomial infection in patients with influenza virus infection 2.
- Another study found that corticosteroid therapy was associated with increased mortality, and the available evidence from observational studies was of very low quality, with confounding by indication a major potential concern 3, 5.
- A prospective, observational, multicenter study found that early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections 4.
Risks and Complications
- Corticosteroid therapy has been associated with increased risk of hospital-acquired pneumonia, longer duration of mechanical ventilation, and longer intensive-care unit stay 1, 2, 4.
- The use of corticosteroids may also be associated with increased mortality, although the evidence is of very low quality and should be interpreted with caution 3, 5.
Current Evidence and Recommendations
- The currently available evidence is insufficient to determine the effectiveness of corticosteroids for people with influenza, and more high-quality research is needed 3, 5.
- The use of corticosteroids as adjunctive therapy in the treatment of influenza should be restricted to very selected cases and in the setting of clinical trials, due to the potential risks and complications associated with their use 1.