Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care

Am Fam Physician. 2020 Jan 15;101(2):89-94.

Abstract

Short-term systemic corticosteroids, also known as steroids, are frequently prescribed for adults in the outpatient setting by primary care physicians. There is a lack of supporting evidence for most diagnoses for which steroids are prescribed, and there is evidence against steroid use for patients with acute bronchitis, acute sinusitis, carpal tunnel, and allergic rhinitis. There is insufficient evidence supporting routine use of steroids for patients with acute pharyngitis, lumbar radiculopathy, carpal tunnel, and herpes zoster. There is evidence supporting use of short-term steroids for Bell palsy and acute gout. Physicians might assume that short-term steroids are harmless and free from the widely known long-term effects of steroids; however, even short courses of systemic corticosteroids are associated with many possible adverse effects, including hyperglycemia, elevated blood pressure, mood and sleep disturbance, sepsis, fracture, and venous thromboembolism. This review considers the evidence for short-term steroid use for common conditions seen by primary care physicians.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Chronic Disease / drug therapy*
  • Drug Prescriptions / statistics & numerical data*
  • Humans
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / methods*
  • Rhinitis / drug therapy
  • Sinusitis / drug therapy
  • Steroids / therapeutic use*

Substances

  • Adrenal Cortex Hormones
  • Steroids