Context: Inhaled corticosteroids (ICS) are associated with an increased risk of pneumonia in adult patients with chronic obstructive pulmonary disease.
Objective: To assess the association between ICS use and risk of pneumonia and other respiratory infections in children with asthma.
Data Sources: We searched PubMed from inception until May 2015. We also searched clinicaltrials.gov and databases of pharmaceutical manufacturers.
Study Selection: We selected randomized trials that compared ICS with placebo for at least 4 weeks in children with asthma.
Data Extraction: We included 39 trials, of which 31 trials with 11 615 patients contributed data to meta-analyses.
Results: The incidence of pneumonia was 0.58% (44/7465) in the ICS group and 1.51% (63/4150) in the placebo group. The meta-analysis of 9 trials that revealed at least 1 event of pneumonia revealed a reduced risk of pneumonia in patients taking ICS (risk ratio [RR]: 0.65; 95% confidence interval [CI]: 0.44 to 0.94). Using risk difference as effect measure, the meta-analysis including all 31 trials revealed no significant difference in the risk of pneumonia between the ICS and placebo groups (risk difference: -0.1%; 95% CI: -0.3% to 0.2%). No significant association was found between ICS and risk of pharyngitis (RR: 1.01; 95% CI: 0.87 to 1.18), otitis media (RR: 1.07; 95% CI: 0.83 to 1.37), and sinusitis (RR: 0.89; 95% CI: 0.76 to 1.05).
Limitations: Lack of clearly defined criteria for respiratory infections and possible publication bias.
Conclusions: Regular use of ICS may not increase the risk of pneumonia or other respiratory infections in children with asthma.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1542/peds.2016-3271 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Factors affecting the prolongation of mechanical ventilation in patients after cardiac surgery.
J Cardiothorac Surg
January 2025
Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Background: This study aimed to investigate the major predictive factors associated with prolonged mechanical ventilation(PMV) following cardiac surgery.
Methods: This retrospective, cross-sectional, descriptive-analytical study was conducted from September 2021 to March 2022, involving 244 patients who underwent cardiac surgery. PMV was defined as mechanical ventilation for more than 24 h.
Immune responses in children with secondary infection of mycoplasma pneumoniae after COVID-19: focus on eosinophils and IgE.
BMC Infect Dis
January 2025
Luoyang Research Center for Inheritance and Innovation of Chinese Historical Civilization, Luoyang Institute of Science and Technology School of Marxism (LIT), No. 90 Wangcheng Avenue, Luolong District, Luoyang City, Henan Province, China.
Background: The COVID-19 (SARS-CoV-2) epidemic has posed a major challenge to global public health, especially in children. Some children may experience secondary infection with Mycoplasma pneumoniae after SARS-CoV-2 infection, which has attracted widespread attention. Studies have shown that eosinophils play an important role in respiratory tract infections and are involved in regulating immune responses and inflammatory processes.
View Article and Find Full Text PDFPlatelet-white cell ratio is more strongly associated with mortality than other common risk ratios derived from complete blood counts.
Nat Commun
January 2025
Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Complete blood count indices and their ratios are associated with adverse clinical outcomes for many acute illnesses, but the mechanisms generating these associations are not fully understood. Recent identification of a consistent pattern of white blood cell and platelet count co-regulation during acute inflammatory recovery provides a potentially unifying explanation. Here we show that the platelet-to-white-cell ratio, which was selected based on this conserved recovery pattern, is more strongly associated with mortality than other blood count markers and ratios in four important illnesses involving acute inflammation: COVID-19, acute heart failure, myocardial infarction, and stroke.
View Article and Find Full Text PDFIndoxyl sulfate (IS) mediates pro-inflammatory responses in severe pneumonia in patients with rheumatoid arthritis associated interstitial lung disease.
Clin Immunol
January 2025
National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/ National Center of Gerontology, China; Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:
Object: Patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) have a high risk of serious infection, in particular severe pneumonia. This study aimed to investigate the transcriptional landscape, lower respiratory tract (LRT) microbiome and metabolomic profiles in the lung of RA-ILD patients with pneumonia.
Method: A total of 10 RA-ILD with pneumonia were enrolled in this study.
Has the documentation of chest injuries and the development of systemic complications in patients with long bone fractures changed over time?-A systematic literature review and meta-analysis by the IMPACT expert group.
Injury
January 2025
Department of Trauma, University of Zurich, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Electronic address:
Introduction: Blunt chest trauma represents a major risk factor for complications in polytrauma patients. Various scoring systems have emerged, but their impact is not fully appreciated. This review evaluates changes in chest trauma scoring over time and potential shifts in complication rates linked to modified surgical approaches in long bone fractures.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!