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Association of oral corticosteroid bursts with severe adverse events in children

JAMA Apr 22, 2021

Yao TC, Wang JY, Chang SM, et al. - Researchers conducted the study for quantifying the associations of oral corticosteroid bursts (defined as the use of oral corticosteroids for 14 or fewer days) with severe adverse events, including gastrointestinal (GI) bleeding, sepsis, pneumonia, and glaucoma, in children. In this investigation, the authors used the de-identified medical claims records and prescription data from the entire National Health Insurance Research Database from January 1, 2013, to December 31, 2017. Of the 4,542,623 children, 23% (1,064,587; 544,268 boys [51.1%]; mean [SD] age, 9.7 [5.8] years) were prescribed a single corticosteroid burst. Acute respiratory tract infections and allergic diseases were the most common indications. This research indicates that corticosteroid bursts, which are widely prescribed for children with respiratory and allergic conditions, are linked to a 1.4- to 2.2-fold increased risk of GI bleeding, sepsis, and pneumonia, but not glaucoma, within the first month after starting corticosteroid therapy that is attenuated during the subsequent 31 to 90 days.

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