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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Related Experiment Video

Updated: May 20, 2025

Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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[Antibiotic prophylaxis when taking corticosteroids].

Gabriel Hans1, Benedek Roska1, Mallory Moret Bochatay1

  • 1Service de médecine interne et des soins intensifs, Groupement hospitalier de l'Ouest lémanique, 1260 Nyon.

Revue Medicale Suisse
|March 27, 2025
PubMed
Summary
This summary is machine-generated.

Antibioprophylaxis prevents Pneumocystis jirovecii pneumonia (PJP) in immunocompromised patients on high-dose corticosteroids. Adhering to guidelines for co-trimoxazole prevents serious adverse effects from unnecessary prophylaxis.

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Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Pharmacology

Context:

  • High-dose corticosteroid therapy increases the risk of opportunistic infections like Pneumocystis jirovecii pneumonia (PJP).
  • Immunocompromised individuals are particularly vulnerable to severe outcomes from PJP.
  • Current guidelines recommend specific criteria for initiating prophylactic antibiotics.

Purpose:

  • To outline the indications for antibiotic prophylaxis in patients receiving high-dose corticosteroid therapy.
  • To emphasize the importance of adhering to established guidelines for co-trimoxazole prophylaxis.
  • To highlight the risks associated with inappropriate antibiotic use.

Summary:

  • Antibioprophylaxis is primarily indicated to prevent Pneumocystis jirovecii pneumonia (PJP) in immunocompromised patients undergoing high-dose corticosteroid treatment.
  • Co-trimoxazole prophylaxis is recommended by the American Thoracic Society and National Comprehensive Cancer Network guidelines for patients receiving corticosteroids at doses ≥20 mg prednisone equivalent daily for ≥28 days.
  • Deviating from these guidelines can lead to unnecessary exposure to co-trimoxazole's severe adverse effects, including agranulocytosis.

Impact:

  • Ensures appropriate patient selection for antibiotic prophylaxis, optimizing treatment efficacy.
  • Reduces the incidence of potentially fatal Pneumocystis jirovecii pneumonia in at-risk populations.
  • Minimizes patient exposure to adverse drug reactions from prophylactic co-trimoxazole, improving safety outcomes.