Corticosteroid Stewardship

Appropriate Use of Short-Term Corticosteroids and Possible Complications

Corticosteroids, also known as steroids, are a class of anti-inflammatory medications that are commonly prescribed by physicians to treat asthma, colds, bronchitis, arthritis, allergies and many other conditions. Frequently, corticosteroids are administered as an injection (shot). However, research shows that such injections are usually not the best option to treat these conditions.

Complications of Inappropriate Corticosteroid Use

Inappropriate use of corticosteroid injections is very common in the Southeast region. This is important to recognize because of potential dangerous side effects when taking steroids. In fact, studies show that a single steroid injection can:

• Increase your chances over the next 1-2 months for infection, bone fracture, and possibly a blood clot
• Cause over the next 1-2 weeks, sleepless nights and jitteriness
• Increase your blood sugars/glucose levels especially if you have diabetes

Improving Appropriate Corticosteroid Use at Ochsner

Ochsner Health Primary Care Physician, Evan Dvorin, MD, received funding from the Excellence Fund and created a quality improvement project concerning the use of corticosteroid injections in the management of acute respiratory tract infections (ARTI) at Ochsner’s Urgent Care Clinics.

The goals of the project include:

• Educating providers about ARTI illness care in general
• Arming providers with concrete guidelines to discuss with patients the appropriateness of corticosteroid use in ARTI care
• Improving the quality of ARTI illness care
• Decreasing variability of corticosteroid administration among providers
• Decreasing harms of ARTI illness care

Meet the Team

The Pharmacy Therapeutic Committee, Ochsner Urgent Care, and Ochsner Primary Care are working together to decrease the inappropriate use of corticosteroid injections. Team members include:

• Evan Dvorin, MD
• Eboni Price-Haywood, MD
• Granville Morse III, MD