Oral Corticosteroid Bursts is linked With Severe Adverse Eve
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A Study was conducted to quantify the associations of corticosteroid bursts with severe adverse events, including gastrointestinal (GI) bleeding, sepsis, pneumonia, and glaucoma, in children.

This cohort study used data derived from the National Health Insurance Research Database on children younger than 18 years of age and used a self-controlled case series design.

The rates of four serious adverse effects (GI bleeding, sepsis, pneumonia, and glaucoma) in children who received or did not receive corticosteroid bursts were determined. The incidence rate ratios (IRRs) of extreme adverse events within 5 to 30 days and 31 to 90 days after the start of corticosteroid bursts were calculated using conditional fixed-effect Poisson regression.

--Among 4542623 children, 23%; mean [SD] age, 9.7 were prescribed a single corticosteroid burst. The most common indications were acute respiratory tract infections and allergic diseases.

--The incidence rate differences per 1000 person-years between children administered a single corticosteroid burst and those not prescribed corticosteroids were 0.60 for GI bleeding, 0.03 for sepsis, 9.35 for pneumonia, and 0.01 for glaucoma.

--The IRRs within 5 to 30 days after initiating corticosteroid bursts were 1.41 for GI bleeding, 2.02 for sepsis, 2.19 for pneumonia, and 0.98 for glaucoma; the IRRs within the subsequent 31 to 90 days were 1.10 for GI bleeding, 1.08 for sepsis, 1.09 for pneumonia, and 0.95 for glaucoma.

In conclusion, corticosteroid bursts, which are often administered for children with respiratory and allergic disorders, are associated with a 1.4- to 2.2-fold increased risk of GI bleeding, sepsis, and pneumonia in the first month after beginning corticosteroid therapy, which decreases in the following 31 to 90 days.

Source: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2778775