CHAPTER 79 ORAL VS. IV STEROIDS IN COPD

Oral or Intravenous Prednisolone in the Treatment of COPD Exacerbations: A Randomized Controlled, Double Blind Study

de Jong YP, Uil SM, Grotjohan HP, Postma DS, Kerstjens HA, van den Berg JW. Chest. 2007;132(6):1741–1747

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with exacerbations being a frequent cause for ED presentation and hospitalization. While systemic corticosteroids have long been a crucial component in the treatment of COPD exacerbations, the ideal route of administration was not known. IV corticosteroid preparations were more often used based on the theoretical concern around the PO delayed onset of action, however, are more costly and difficult to administer. At the time of this study, no evidence existed comparing the efficacy of oral and IV routes of corticosteroid administration.

OBJECTIVES

To determine if oral prednisolone is not inferior to IV prednisolone in treatment of patients hospitalized with COPD exacerbations.

METHODS

Randomized, double-blind trial at one hospital center between 2001 and 2003.

Patients

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