The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: an overview of reviews

Abstract BackgroundAcute respiratory conditions are a leading cause of childhood morbidity and mortality. Corticosteroids are effective and established treatments in some acute respiratory infections (e.g. croup) and asthma exacerbations; however, their role is controversial in other conditions owing to inconsistent effectiveness or safety concerns (e.g. bronchiolitis, acute wheeze). ObjectivesTo examine clinically relevant short‐term safety outcomes related to acute single or recurrent systemic short‐term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions. MethodsWe searched the Cochrane Database of Systematic Reviews in February 2013 for systematic reviews comparing systemic corticosteroids with placebo for children (aged 0–18 years) with acute asthma, preschool wheezing, bronchiolitis, croup, pharyngitis/tonsillitis or pneumonia. We selected the following outcomes a priori: gastrointestinal (GI) bleeding and abdominal pain; behavioural effects (tremor or hyperactivity, jitteriness, irritability or emotional distress); hypertension; serious adverse events, including death, length of stay in hospital; and relapse leading to hospitalization. One reviewer extracted data and another reviewer independently verified data. Results were combined using Peto odds ratios and risk differences (RD) for dichotomous outcomes and mean differences for continuous outcomes. Main resultsSeven reviews containing 44 relevant randomized controlled t...
Source: Evidence-Based Child Health: A Cochrane Review Journal - Category: Pediatrics Authors: Tags: Overview of Reviews Source Type: research