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Inhaled corticosteroids increased risk for recurrent pneumonia in older adults
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The use of corticosteroid inhalants was associated with a nearly twofold increased risk for recurrent pneumonia among high-risk pneumonia survivors aged at least 65 years, new findings suggest.
"In patients currently using inhaled corticosteroids (ICS) who present with pneumonia, the continued need for ICS should be re-evaluated," study researcher Dean T. Eurich, PhD, MSc, associate professor at the School of Public Health, University of Alberta, told Infectious Disease News. “If for symptom control, there may be other, safer options that clinicians may be able to use in their patients (eg, long-acting beta-agonists)."
Dean T. Eurich
In a nested case-control study, Eurich and colleagues examined the risk for recurrent pneumonia in 2,479 older adults who survived their initial hospitalization or ED visit for community-acquired pneumonia. A total of 653 recurrent pneumonia cases (CAP hospitalization ≥30 days after initial hospitalization) were matched with 6,244 controls by age, sex, history of chronic obstructive pulmonary disorder, and pre-pneumonia use of inhaled corticosteroids.
According to the researchers, 26% of patients had recurrent pneumonia during 5 years of follow-up; 14% of those who used corticosteroid inhalants had recurrent pneumonia vs. 9% of those who never used the treatment (adjusted OR=1.9; 95% CI, 1.45-2.5). The researchers found no association between past use of corticosteroid inhalants and pneumonia (9% of past users vs. 9% of those who never used inhalants).
"If ICS is to help reduce the risk for exacerbations, clinicians need to be aware that a trade-off exists and reductions in exacerbations come at an increased risk for recurrent pneumonia," Eurich said. "Indeed, one in 20 patients who continue to use ICS will re-develop pneumonia over the next 5 years."
Disclosure: Eurich reports no relevant financial disclosures.
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