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Oral Corticosteroids and First Do No Harm

Oral Corticosteroids and First Do No Harm

One of every 5 privately insured American adults younger than 64 years received a prescription for short-term use of oral corticosteroids over a 3-year period. The short-term prescribing of oral corticosteroids in this group was associated with higher rates of sepsis, venous thromboembolism, and bone fractures.

Long-term systemic corticosteroid use is known to lead to adverse effects, but Akbar Waljee and colleagues at the University of Michigan pointed out that studies examining complications associated with short-term steroid use are lacking.

Corticosteroids are a common reason for admission to a hospital for drug-associated adverse events, the researchers noted. Extended use of oral corticosteroids is associated with infections, deep vein thrombosis, avascular necrosis, and bone fractures and may lead to chronic disease states, such as diabetes, hypertension, osteoporosis, and drug-induced Cushing syndrome.

The authors presented the results of their investigation into the consequences of short-term oral corticosteroid treatment in a recent British Medical Journal article.

The study

In this large retrospective, population-based, cohort study, the investigators assigned 1,548,945 adults younger than 64 years to 2 groups, those who received at least 1 outpatient prescription for short-term oral corticosteroids and those who received no oral steroids. They were assessed for 3 acute adverse events: sepsis, venous thromboembolism, and fractures.

The results

• 21% of subjects received at least 1 outpatient prescription for short-term oral corticosteroids during the study period.

• The median number of days the oral steroids were used was 6; 47.4% of users took them for more than 7 days.

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