Inhaled corticosteroids increase pneumonia risk in asthma

Research from the UK indicates that the use of inhaled corticosteroids is independently associated with an increased risk for pneumonia and lower respiratory tract infection (LRTI) in patients with asthma.

The findings, reported in Chest, show that asthma patients who had pneumonia or LRTI were 24% more likely to have received a prescription for inhaled corticosteroids in the prior 90 days than were asthma patients without infection.

Overall, 3425 (49.9%) of 6857 patients with asthma who had pneumonia or LRTI had a recent prescription compared with 12,169 (33.5%) of their 36,312 age- and gender-matched controls with asthma.

Furthermore, the team from the University of Nottingham observed a dose-dependent relationship, such that those receiving inhaled corticosteroids over 1000 µg daily were 2.04 times more likely to have pneumonia or LRTI than were controls. This relationship was even stronger when the authors considered pneumonia alone, for which the risk increased 2.37-fold with high-dose corticosteroid use, while the risk for LRTI increased 1.75-fold.

“Our results suggest that the dose of [inhaled corticosteroid] prescribed should be kept to the minimum necessary and that the dose should be stepped down if the patient is well controlled,” say the authors, led by Dominick Shaw. They also note that it may be important for physicians to consider whether infection is responsible for recurrent symptoms before increasing the current dose of steroids.

An association between the use of inhaled corticosteroids and pneumonia in chronic obstructive pulmonary disease was recently reported, and asthma is a known risk factor for invasive pneumococcal disease, the team explains.

However, the mechanism by which steroids influence pneumonia risk and bacterial numbers in asthma is unknown.

“A review and meta-analysis of asthma studies involving [inhaled corticosteroids] and an exploration of the effect of [inhaled corticosteroids] on the lung microbiota are now required,” they conclude.

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.

Kirsty Oswald

Written by

Kirsty Oswald

Kirsty has a B.Sc. in Human Sciences from University College London. After several years working as medical copywriter, she became a medical journalist and is now freelance. Kirsty also works part-time as an editor for a London-based charity. She is particularly interested in the social and cultural aspects of science.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Oswald, Kirsty. (2018, August 23). Inhaled corticosteroids increase pneumonia risk in asthma. News-Medical. Retrieved on July 03, 2022 from

  • MLA

    Oswald, Kirsty. "Inhaled corticosteroids increase pneumonia risk in asthma". News-Medical. 03 July 2022. <>.

  • Chicago

    Oswald, Kirsty. "Inhaled corticosteroids increase pneumonia risk in asthma". News-Medical. (accessed July 03, 2022).

  • Harvard

    Oswald, Kirsty. 2018. Inhaled corticosteroids increase pneumonia risk in asthma. News-Medical, viewed 03 July 2022,


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
You might also like...
Allergic asthma, allergies may be associated with the risk of cardiovascular diseases