Long Term (Five or More Years) Administration of Corticosteroids in Pulmonary Diseases

¹ Broad Street Hospital and Medical Center, Wolffe Hospital, Philadelphia General Hospital and Germantown Hospital

Long term, maintenance or supportive (2 to 12 mg. daily) treatment with corticosteroids is often necessary to maintain symptomatic improvement. In this study, we found the same clinical action whether the corticoid was given once daily, or in divided doses. This tends to confirm the recent report of Demos, et al.⁹ on once daily therapy.

The beneficial effects can be complicated by undesirable side reactions. For supportive and prophylactic care, all patients were on high protein diets (re: osteoporosis); in between feedings, milk, etc. (re: ulcer); adequate water intake (avoiding a concentrated urine with hypercalciuria); isoniazid 100 mg. three times a day (against reactivating tuberculosis) with regular complete examinations, including laboratory evaluation. The concurrent administration of anabolic steroids (androgen and estrogen) has been shown to control osteoporosis. Unfortunately, the moon faces often appear early in the course of treatment and persist in a large group of patients.

Finally, the corticosteroids are potent, effective drugs for acute and chronic pulmonary diseases. They should be used with discretion, when indicated, under close clinical supervision.