Related Experiment Video

Updated: Jul 9, 2026

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids
08:02

Fecal Glucocorticoid Analysis: Non-invasive Adrenal Monitoring in Equids

Published on: April 25, 2016

Hydrocortisone use in France: current practices in 2026

Alexandra Nuytten1, Said Maallem2, Marie Buttitta2

  • 1Department of Neonatology, Saint Vincent de Paul Hospital, Lille Catholic Hospitals, Lille, France. nuytten.alexandra@ghicl.net.

European Journal of Pediatrics
|July 8, 2026
PubMed

Insights

French neonatal intensive care units show varied use of early prophylactic hydrocortisone in extremely preterm infants. Updated national guidelines are needed to harmonize evidence-based care for these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Pharmacology
  • Evidence-Based Medicine

Background:

  • Recent evidence supports prophylactic hydrocortisone for improved survival without bronchopulmonary dysplasia in extremely preterm infants.
  • Current French national recommendations (2010) on postnatal corticosteroids are outdated, focusing only on late use and not incorporating the latest evidence.

Purpose of the Study:

  • To provide a national overview of prophylactic hydrocortisone prescribing practices in French neonatal intensive care units (NICUs).
  • To identify the extent of use and reasons for non-use of early prophylactic hydrocortisone.
  • To highlight the need for updated national guidelines.

Main Methods:

  • A national survey was conducted between June 1 and August 13, 2024, targeting all 66 French level III NICUs.
  • A structured online questionnaire was used, with one response collected per center.
  • Fifty-five NICUs (83%) responded to the survey.

Main Results:

  • Prophylactic hydrocortisone was used in 60% of responding NICUs (33 centers), either systematically (29%) or selectively (31%).
  • Among users, 64% targeted the same infant population as the PREMILOC study.
  • Non-users cited concerns regarding benefit-risk balance, lack of evidence, and absence of national guidelines. Fear of neurodevelopmental risk was significantly higher among non-users.

Conclusions:

  • Hydrocortisone use in French NICUs remains heterogeneous, influenced by safety concerns and perceived uncertainty regarding evidence strength.
  • Discrepancies between current evidence and clinical practice were identified.
  • Updated national guidelines are essential for harmonizing evidence-based care for extremely low gestational age newborns (ELGANs).

Keywords:
ELGANs (extremely low gestational age newborn)HydrocortisoneNational surveyPostnatal corticosteroids

Related Concept Videos

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

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.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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 (COX-2),...
COPD: Management Using Bronchodilators and Corticosteroids01:26

COPD: Management Using Bronchodilators and Corticosteroids

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...
Drug Delivery: Miscellaneous Routes01:22

Drug Delivery: Miscellaneous Routes

Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection,  and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs through the...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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 Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...