Older adults who use steroid inhalers to treat asthma or chronic
obstructive pulmonary disease (COPD) are more likely to develop bacterial
infections, according to a study.
Worldwide, asthma and COPD affect hundreds of thousands of people and are often
treated with steroid inhalers to reduce symptoms and improve lung function.
However, the new study suggests that these inhalers also increase the risk of
developing lung infections caused by non-tuberculous mycobacteria, which are
notoriously difficult to treat and resistant to a number of common antibiotics.
The study was conducted at the University of Toronto, Canada. The authors noted
that such infections are not particularly common, but they are chronic,
associated with an increased risk of death, and difficult to treat. Usually,
treatment requires at least three antibiotics over a year or more, but this may
not solve the problem of an infectious disease.
The study included about 450,000 people with COPD or asthma, aged sixty-six or
older, who were prescribed at least one medication for their condition. It
turned out that 2,966 were also diagnosed with non-tuberculous mycobacteria
infections, and experts compared this information with whether these patients
used steroid inhalers, the type of steroid they used, and the number of
applications. It was found that in people who used steroid inhalers , were
twice as likely to be diagnosed with this type of infection, and the longer
they took the steroid, the higher the risk. The scientists also found that one
particular type of steroid was particularly effective in this regard. Previous
research has shown that steroid inhalers interfere with the body’s ability to
fight infections by reducing or weakening cells in the immune system. According
to the authors, such inhalers are critical treatments for asthma symptoms in
most patients. Although work has also shown that they provide benefits to
patients with COPD, such agents are less important in the management of this
condition and may only provide more benefit than harm in a subset of patients
with COPD. There is an ongoing debate about which COPD patients should be
treated with inhaled steroids.