Inhaled corticosteroids increase risk of Pneumonia

by Bruce Sylvester – Investigators suggest caution in prescribing inhaled corticosteroids to high-risk patients such as pneumonia survivors, after their research shows a twofold risk for repeat infection.

The research was published in the August 2013 issue of Clinical Infectious Diseases.

Dean Eurich, PhD,  assistant professor, School of Public Health, University of Alberta, Edmonton, Alberta, Canada and his research team evaluated inhaled corticosteroid use among elderly patients, enrolling over 6,200 seniors who had survived an initial episode of pneumonia and who had  a high risk of repeated respiratory infection.

Over the five-year period of the study, they found that 653 subjects had suffered a repeat episode of infection. Notably, inhaled corticosteroid use was associated with a 90 per cent increase in risk for repeat infection, when compared with non-use.

“Given the evidence starting to emerge on inhaled corticosteroids, health professionals have to use their own clinical judgement to try and determine which patients should remain on the drugs, especially for patients with pneumonia,” said Eurich.

Physicians use inhaled corticosteroids to treat asthma and chronic obstructive pulmonary disease, chronic bronchitis and emphysema, and other respiratory disorders, like nagging cough. While researchers in other, smaller studies have examined the risk of developing pneumonia with inhaled corticosteroid use, this new study is the first examine a large group of high-risk seniors.

Given the uncertainty of the connection between inhaled corticosteroids and repeat infection in this group, Eurich said, “Continue on your medications as your health professional has told you to use them. If you’re feeling unwell, if you are coughing or wheezing more, are more short of breath than usual, have chest pain when breathing deeply or coughing, feel fatigued, or develop a fever, see a physician sooner rather than later.”

The research was funded by Alberta Innovates — Health Solutions and the Canadian Institutes of Health Research.