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There have been concerns about growth suppression in children use intranasal corticosteroids, although these effects are considered small and inconsistent. A recent comprehensive review concluded that these indications are not reliable for use of corticosteroids beyond the first few years of life.[1] An evaluation of the literature, primarily on pediatric settings, revealed limited evidence on the efficacy of intranasal corticosteroids in early childhood. A meta-analysis concluded that there is moderate evidence that intranasal corticosteroids improve lung function in the early years, but not in later years.[2] A comparison of the incidence of respiratory disorders in children with poor lung function and those with strong lung function found a significant reduction in the latter age group.[3] Evidence from observational studies suggested a reduction in respiratory problems in children use intranasal corticosteroids with other immunosuppressant drugs at the same dose; however other studies did not. Intranasal corticosteroids are used primarily to treat allergic rhinitis. Many types of immunosuppressant drugs can be used as an adjunct to corticosteroids; however, the most frequent and well-described use of intranasal corticosteroids involves a multispecies immunogen (antibody) therapy and intranasal administration. Because corticosteroids cannot stimulate the immune system to eliminate and kill pathogens, they should be reserved for very serious allergic conditions such as multiple sclerosis, lupus, and sarcoidosis, as well as for chronic and severe asthma. Other indications for intranasal corticosteroids are a variety of neurologic conditions, inflammatory bowel disease, and some metabolic disorders.[4] Intranasally administered corticosteroids are contraindicated in children with suspected serious respiratory diseases, such as asthma, or severe immunosuppression, including AIDS or HIV infection; chronic lung disease; malignancy; or cancer. Use of intranasal corticosteroids in children with suspected serious respiratory diseases, as well as in children with suspected life-threatening immunosuppressive diseases may increase the risk of serious adverse effect; in some cases, discontinuation of intranasal corticosteroids with other immunosuppressants has not successfully reversed the adverse effect.[5] Patients The use of intranasal corticosteroids in children has been limited by a lack of published evidence on their efficacy. There are several limitations. First, because corticosteroids affect the immune system differently from naturally occurring immunosuppressant drugs Similar articles:
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