Steroid Use in Respiratory Conditions

Introduction to Steroid Use

The American College of Physicians recommends that systemic corticosteroids are not justified for acute bronchitis in healthy adults, as the clinical course is self-limited, resolving spontaneously after approximately 10 days 1
The American Thoracic Society suggests that purulent sputum does not indicate bacterial superinfection and does not justify steroid treatment in uncomplicated acute bronchitis 1

The American College of Chest Physicians recommends initial therapy including inhaled corticosteroids combined with bronchodilators for asthma patients presenting with cough 2
For severe or refractory asthmatic cough, a short course of oral corticosteroids followed by inhaled corticosteroids is recommended by the National Asthma Education and Prevention Program 2
The Global Initiative for Asthma suggests that inhaled corticosteroids should be continued long-term for maintenance in asthma patients 2

The Global Initiative for Chronic Obstructive Lung Disease recommends systemic corticosteroids for acute exacerbations of COPD, with a standard regimen of prednisone 40 mg daily for 5-7 days 1, 4
The American College of Chest Physicians suggests that long-term oral corticosteroids should not be used for maintenance therapy in stable chronic bronchitis, but inhaled corticosteroids may be beneficial for patients with severe disease 4

The American College of Physicians warns that corticosteroids can cause significant side effects, including immunosuppression, hyperglycemia, and osteoporosis, particularly with prolonged use 4
The European Respiratory Society notes that intranasal steroids are ineffective for common cold symptoms, including cough 5
The American Thoracic Society recommends that inhaled corticosteroids should not be routinely prescribed for chronic cough in patients with idiopathic pulmonary fibrosis or sarcoidosis 6, 7