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Steroids ineffective for chest pains in non-asthmatic patients, says new study

Researchers find no reduction in duration of cough, the main symptom of chest infections between two and four days after treatment.

Washington DC: According to a new research, Oral steroids should not be used for treating acute lower respiratory tract infection or chest pains in adults who don't have asthma or other chronic lung disease, as they do not reduce the duration or severity of symptoms.

In the study, 398 non-asthmatic adults with acute chest infections but no evidence of pneumonia and not requiring immediate antibiotic treatment were randomly split into two groups.

One group received 40mg of the oral steroid 'prednisolone' for five days (198 participants) and other received an identical placebo over the same time period (200 participants).

The team found there was no reduction in the duration of cough, the main symptom of chest infections, or the severity of the accompanying symptoms between two and four days after treatment (when symptoms are usually at their most severe) in the prednisolone group compared with the placebo group.

The results suggest that steroids are not effective in the treatment of chest infections in non-asthmatic adult patients.

"Chest infections are one of the most common problems in primary care and often treated inappropriately with antibiotics.

Corticosteroids, like prednisolone, are increasingly being used to try to reduce the symptoms of chest infections, but without sufficient evidence," said Alastair Hay, a GP and Professor of Primary Care in the Bristol Medical School at the University of Bristol and study's lead author.

Adding, "Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity. We would not recommend their use for this group of patients."

Study's co-author Professor Mike Moore, added, "Oral and inhaled steroids are known to be highly effective in treating acute asthma as well as infective flares of other long-term lung conditions but need to be used carefully because of the risk of unwanted side effects."

He concluded by saying, "We chose to test the effect of steroids for chest infections as some of the symptoms of chest infections, such as shortness of breath, wheeze and cough with phlegm, overlap with acute asthma. However, we have conclusively demonstrated they are not effective in this group of patients."

The study was published in journal JAMA.

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