Corticosteroids in the Treatment of Tuberculous Pleurisy

Lee, Cheng-Huei; Wang, Wen-Jye; Lan, Ray-Shee; Tsai, Ying‐Huang; Chiang, Ying-Chieh

doi:10.1378/chest.94.6.1256

Cited by 127 publications

(45 citation statements)

References 5 publications

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“…[107][108][109][110] One trial enrolled only HIV-infected adults, 107 and all antituberculous regimens included rifampin.…”

Section: Pleural Tuberculosismentioning

confidence: 99%

“…If the amount removed was small, 107,110 corticosteroids accelerated resolution of fever, chest pain, and dyspnea 110 and hastened resolution of the effusion. 107,110 If the amount of pleural fluid initially removed was large (eg, chest tube drainage after pleural biopsy), however, corticosteroids were ineffective.…”

Section: Pleural Tuberculosismentioning

confidence: 99%

“…108,109 They provided no long-term benefit in pulmonary function measured 6 and 12 months later, 108,109 residual radiographic pleural thickening, [108][109][110] and mortality. 107 The only important adverse effect occurred in HIV-infected patients, 107 in whom corticosteroid use was associated with more Kaposi sarcoma during a median of 18 months' follow-up (6 vs 0 cases).…”

Section: Pleural Tuberculosismentioning

confidence: 99%

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Use of Corticosteroids in Treating Infectious Diseases

McGee¹

2008

Arch Intern Med

109

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linicians have generally avoided prescribing corticosteroids for active infection because of their known immunosuppressive effects and concern about long-term complications. We conducted a review of the published randomized, double-blind trials comparing corticosteroids and placebo in infections. Except in some trials of viral infections, sore throat, and cerebral cysticercosis, all patients also received active antimicrobial agents in addition to placebo or corticosteroids. For patients with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis, severe typhoid fever, tetanus, or pneumocystis pneumonia with moderate to severe hypoxemia, treatment with corticosteroids improved patient survival (group 1 infections). For patients with bacterial arthritis, corticosteroids were also beneficial and reduced long-term disability (group 2 infections). For about a dozen other infections, corticosteroids significantly relieved symptoms (group 3 infections), and clinicians should consider using them if symptoms are substantial. Corticosteroids were harmful in 2 infections, viral hepatitis and cerebral malaria (group 5 infections). We conclude that corticosteroids are beneficial and safe for a wide variety of infections, although courses longer than 3 weeks should be withheld from patients with concomitant human immunodeficiency virus infection and low CD4 counts.

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“…[107][108][109][110] One trial enrolled only HIV-infected adults, 107 and all antituberculous regimens included rifampin.…”

Section: Pleural Tuberculosismentioning

confidence: 99%

Section: Pleural Tuberculosismentioning

confidence: 99%

Section: Pleural Tuberculosismentioning

confidence: 99%

See 1 more Smart Citation

Use of Corticosteroids in Treating Infectious Diseases

McGee¹

2008

Arch Intern Med

109

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“…18 Corticosteroids may also shorten the acute phase of illness, and prevent damage to the pleura and pleural effusion. A double-blind studyl8 compared 21 patients with tuberculous pleurisy who received corticosteroids and antituberculosis medications with 19 patients who received antituberculous drugs alone.…”

Section: Adjunctive Use Ofcorticosteroidsmentioning

confidence: 99%

“…The authors concluded that prednisone may be considered in patients with pleuritic chest pain and definite tuberculous pleurisy until symptoms subside. 18 …”

Section: Adjunctive Use Ofcorticosteroidsmentioning

confidence: 99%