Corticosteroids may mask some signs of infections and new infections may appear. A decreased resistance to localized infection has been observed during corticosteroid therapy. Patients should be advised to inform subsequent physicians of the prior use of corticosteroids. There may be enhanced systemic effects of budesonide in patients with an advanced liver cirrhosis, and in those with hypothyroidism. ASA should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia.
Special care is needed in patients with lung tuberculosis and fungal and viral infections.
Children who are on immunosuppressant drugs are more susceptible to infections than healthy children. Chickenpox and measles, for example, can have a more serious or fatal course in children on immunosuppressant corticosteroids. In such children, or in adults who have not had these diseases, particular care should be taken to avoid exposure. If chickenpox develops treatment with antiviral agents may be considered. If, however, a viral upper respiratory infection is present, the patient should adhere to the regular asthma medication.