Virus World

Oral steroid use in patients with the inflammatory diseases polymyalgia rheumatica and/or giant cell arteritis significantly increased the risk of infection, and the risk increased with higher doses, found a study in CMAJ.

 

In a large study of almost 40 000 adult patients with polymyalgia rheumatica or giant cell arteritis in England, researchers found higher absolute risks of infection when patients were taking oral steroids than when they were not taking them. The mean age of patients in the study was 73 years. Steroids included prednisolone, prednisone, hydrocortisone and cortisone. The risk of infection increased with higher doses and was elevated even with low daily doses of less than 5 mg of prednisolone.

 

More than half of patients (22 234, 56%) had infections during 138 412 person-years of follow up, with the most common infections being lower respiratory tract infections (27%), conjunctivitis (9%) and shingles (7%). More than one-quarter (27%) of patients were admitted to hospital and 7% died within a week of diagnosis of infection.