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Corticosteroids for acute and subacute cough following respiratory tract infection: a systematic review

Corticosteroids for acute and subacute cough following respiratory tract infection: a systematic review
Corticosteroids for acute and subacute cough following respiratory tract infection: a systematic review
Background: cough associated with acute respiratory tract infection (RTI) is one of the most common problems managed in primary care. Despite minimal evidence for the use of antibiotics, they continue to be prescribed at great cost and are a significant cause of emerging bacterial resistance.

Objectives: to carry out a systematic review of randomized controlled trials to evaluate the effect of corticosteroid therapy in otherwise-healthy adults with acute RTI.

Methods: seven electronic databases and five ongoing trial registers were searched. Studies were eligible if they compared the use of any corticosteroid treatment against a control group in adults with an acute (<3 weeks) or subacute (<8 weeks) cough associated with an RTI but no asthma. Primary outcomes were differences in mean cough and other symptom scores. Secondary outcomes included adverse effects, subsequent diagnosis of asthma and patient satisfaction.

Results: four trials (335 participants) investigating the effects of inhaled corticosteroids were identified. None investigated the use of oral corticosteroids. Results were mixed, with two reporting equivalence and two reporting benefits for mean cough score (P = 0.012) and cough frequency (P = 0.047). One reported additional benefits in non-smokers. Adverse events were rare and there were no data on patient satisfaction or the subsequent diagnosis of asthma. Most trials were of unclear risk of bias. Study outcomes were too heterogeneous to meta-analyse.

Conclusions: there is insufficient evidence to recommend the routine use of inhaled corticosteroids for acute RTI in adults. However, some trials have shown benefits, suggesting the need for further high-quality, adequately powered trials
bronchitis, cough, general practice, glucocorticoids, primary health care, respiratory tract infections
0263-2136
492-500
El-Gohary, Magdy
392c5e6d-a761-4577-967f-2f36054aa653
Hay, Alastair D.
bfae9e44-ae9b-473c-923f-1dea50747023
Coventry, Peter
b1a65d17-2d16-4441-b180-05e7abb6dc87
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
El-Gohary, Magdy
392c5e6d-a761-4577-967f-2f36054aa653
Hay, Alastair D.
bfae9e44-ae9b-473c-923f-1dea50747023
Coventry, Peter
b1a65d17-2d16-4441-b180-05e7abb6dc87
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

El-Gohary, Magdy, Hay, Alastair D., Coventry, Peter, Moore, Michael, Stuart, Beth and Little, Paul (2013) Corticosteroids for acute and subacute cough following respiratory tract infection: a systematic review. Family Practice, 30 (5), 492-500. (doi:10.1093/fampra/cmt034). (PMID:23836094)

Record type: Article

Abstract

Background: cough associated with acute respiratory tract infection (RTI) is one of the most common problems managed in primary care. Despite minimal evidence for the use of antibiotics, they continue to be prescribed at great cost and are a significant cause of emerging bacterial resistance.

Objectives: to carry out a systematic review of randomized controlled trials to evaluate the effect of corticosteroid therapy in otherwise-healthy adults with acute RTI.

Methods: seven electronic databases and five ongoing trial registers were searched. Studies were eligible if they compared the use of any corticosteroid treatment against a control group in adults with an acute (<3 weeks) or subacute (<8 weeks) cough associated with an RTI but no asthma. Primary outcomes were differences in mean cough and other symptom scores. Secondary outcomes included adverse effects, subsequent diagnosis of asthma and patient satisfaction.

Results: four trials (335 participants) investigating the effects of inhaled corticosteroids were identified. None investigated the use of oral corticosteroids. Results were mixed, with two reporting equivalence and two reporting benefits for mean cough score (P = 0.012) and cough frequency (P = 0.047). One reported additional benefits in non-smokers. Adverse events were rare and there were no data on patient satisfaction or the subsequent diagnosis of asthma. Most trials were of unclear risk of bias. Study outcomes were too heterogeneous to meta-analyse.

Conclusions: there is insufficient evidence to recommend the routine use of inhaled corticosteroids for acute RTI in adults. However, some trials have shown benefits, suggesting the need for further high-quality, adequately powered trials

Full text not available from this repository.

More information

Accepted/In Press date: 6 June 2013
Published date: 8 July 2013
Keywords: bronchitis, cough, general practice, glucocorticoids, primary health care, respiratory tract infections
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 355521
URI: https://eprints.soton.ac.uk/id/eprint/355521
ISSN: 0263-2136
PURE UUID: 6767aee4-679a-4a5f-baac-200a58a33a2c
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 02 Sep 2013 08:00
Last modified: 20 Jul 2019 00:57

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Contributors

Author: Magdy El-Gohary
Author: Alastair D. Hay
Author: Peter Coventry
Author: Michael Moore ORCID iD
Author: Beth Stuart
Author: Paul Little

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