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Steroids

Matthew DeLaney, MD, FACEP, FAAEM
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25:35
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No me gusta!

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Steroids are commonly used to treat a wide variety of conditions. The existing data suggests that oral formulations are as effective as IM or IV.

In terms of their efficacy there are some conditions where steroids clearly work, some where they are commonly used despite unclear data, and some where the data convincingly shows that steroids do not work.

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Mike W., MD -

I was happy that Matt Delaney did a review on steroids. As usual he is very informative and practical. One thing I wish he would have discussed was the differences between all the steroids out there. Are all steroids created equal? In my urgent care clinic we have several different steroids available. Each of our providers has a favorite. Which one is best? Does it matter which one is used? Perhaps Delaney could do a follow up discussion or maybe Bryan Hayes could do a segment.
Thanks for all you do. You make a difference in my practice and I look forward to listening Urgent Care RAP every month!
Ed Anderson

Mike W., MD -

Great question, the overall literature is really unclear in terms of the differences between different steroids. Most of the studies that we talked about in the segment actually used different formulations and oftentimes different routes of administration. There is a lot of anecdotal evidence out there but in terms of reliable scientific information the best we can tell is that any type of steroid probably confers some benefit for the conditions we discussed but also has some associated risks. It would be great to have studies to clarify this further but unfortunately steroids are pretty cheap and there does not seem to be a lot of movement in the research community to run big studies that would decidedly answer this question
Matt Delaney

Mizuho M., DO -

Ed thanks for your comments! Great suggestion. Oral/parenteral steroids is a good topic and we will certainly ask Bryan and Matt to dig a bit deeper. But even more exciting (for me personally) is an upcoming segment on differences in TOPICAL steroids with Britt Declerk MD (dermatolgist/pathologist). I find the selection of which topical steroid to use for what so confusing and end up under-treating out of fear of high potency steroids much of the time. We can do much better...so standby for both of these discussions! Thanks for the comments! Keep them coming! ~Miz

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Better Put A Ring On It Full episode audio for MD edition 196:02 min - 92 MB - M4AHippo UC RAP May 2018 Written Summary 367 KB - PDF