Format

Send to

Choose Destination
Pediatrics. 2017 Mar;139(3). pii: e20163271. doi: 10.1542/peds.2016-3271.

Inhaled Corticosteroids and Respiratory Infections in Children With Asthma: A Meta-analysis.

Author information

1
Postgraduate Program in Public Health.
2
Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil; and.
3
Department of Respiratory and Sleep Medicine, Lady Cilento Children's Hospital and School of Medicine, The University of Queensland, Brisbane, Australia.
4
Postgraduate Program in Public Health, lzhang@furg.br.
5
Postgraduate Program in Health Science, and.

Abstract

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.

PMID:
28235797
DOI:
10.1542/peds.2016-3271
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center