Annals Consult Guys - Cough: Burst Steroids or No Steroids?
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2020)

Web Exclusives18 August 2020Annals Consult Guys - Cough: Burst Steroids or No Steroids?FREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this author and Howard H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W19-0041 CME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This episode of Annals Consult Guys addresses the effectiveness and safety of short courses of oral corticosteroids for the treatment of cough associated with upper respiratory tract infection.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Peter Robie MD FACPWake Forest Baptist Health19 August 2020 Comment on Annals Consult Guys Great discussion! In these patients I check if they are on ACE inhibitors or ARBS, sometimes their cough gets better quicker if these medicines are held until the cough is gone. Is this just my imagination, or is there any scientific evidence for doing this? Thank you! Disclosures: none Evan DvorinOchsner Medical Center, New Orleans, LA19 August 2020 Updated information on frequency of steroid use for ARTIs Dear Drs. Merli and Weitz, thank you for addressing this important issue on whether to use steroid for acute cough. We have published 2 papers in 2020 with updated information on frequency of steroid use for ARTIs. We have found that steroids are given even more frequently now than they were one decade ago. There has been a significant increase in systemic steroid use in office visits for ARTIs nationally from 2007 (10.5% of ARTIs office visits) to 2016 (16.3% of office visits). Overall, nearly half of these short-term systemic steroids are administered by injection, which is especially common in the southern US (1). We also found that steroids are similarly prescribed during telemedicine video encounters for ARTIs (2). Clearly many healthcare providers are in urgent need for education regarding short term steroid use, as you have provided here in a thoughtful and engaging way. There is a clear need for developing a national corticosteroid stewardship campaign with the goal to decrease inappropriate corticosteroid use for ARTIs, which is not evidence based, and is costly and potentially harmful. Lin KJ, Dvorin E, Kesselheim AS. Prescribing systemic steroids for acute respiratory tract infections in United States outpatient settings: A nationwide population-based cohort study. PLoS Med. 2020;17(3). Dvorin EL, Rothberg MB, Rood MN, Martinez KA. Corticosteroid Use for Acute Respiratory Tract Infections in Direct-to-Consumer Telemedicine. Am J Med. 2020;133(8):e399-e405. Disclosures: None David WarrenNone25 August 2020 Give Feedback to AACP Guidelines for Post-infectious Cough Hi Guys, I hope you inform the AACP committee on Post-infectious Cough about your archeological dig finding. Data on 6 patients, should not be the basis for making a recommendation, especially in light of the risks data that is now available. David Blais MDHospitalist, Sentara Hospitals24 September 2020 Where are the diabetic complications? I am surprised there is no reference to diabetic decompensation with short courses of sterod therapy. Hospitalizing patients for blood sugars over 500 after a course of short term steroids is as they would say "not uncommon". Mark Antony LaPorta MD FACPMark Antony LaPorta MD FACP5 November 2020 cough after URI A common cause of sub-acute post-URI nonproductive cough is POST NASAL DRIP, easily relieved but a proper application of nasal saline for a few days or more. Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Disclosures: Geno J. Merli, MD, and Howard H. Weitz, MD, report that they have no financial relationships or interests to disclose.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he has no financial relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 August 2020Volume 173, Issue 4Page: CG1KeywordsDiagnostic techniquesDisclosureRespiratory system proceduresSafetySteroidsUpper respiratory tract infections ePublished: 18 August 2020 Issue Published: 18 August 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...