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Background and study aims
Most people get at least one chest infection every year and a high proportion present to health services and need to take time off work/other responsibilities. Symptoms are frequently prolonged (lasting 3 to 4 weeks) and no treatment (including antibiotics) has been shown to reduce either symptom severity or duration. Despite this, and strong evidence that inappropriate antibiotic prescribing fuels the development of the antibiotic-resistant bacterial strains (including MRSA), around 75% of adults presenting to GPs are still prescribed antibiotics. Many of the symptoms of chest infections (cough, phlegm, shortness of breath and wheeze) overlap with those of asthma attacks. While there is good evidence that steroids help patients with asthma, very little research has been conducted to assess if steroids can have the same beneficial effects in non-asthmatic patients suffering from chest infections. More evidence is needed to help doctors to understand if a high dose of steroids (given by tablets) are better than antibiotics, and could help doctors and patients to rely less on antibiotics. A high dose has been selected to maximise the chances of the study detecting an effect. If effects are found, lower doses will be tested in the future.
Who can participate?
Non-asthmatic adults with a chest infection
What does the study involve?
Participants are randomly allocated to be given either a 5-day course of (active) steroid tablets or placebo (dummy) tablets. They are asked to complete a daily symptom diary for up to 4 weeks.
What are the possible benefits and risks of participating?
If the use of steroids was to reduce the annual cost of treating chest infections by as little as 1%, then the NHS would recoup the cost of the study in one year. Participation will not affect patients’ access to all other aspects of usual care and, in an emergency, their doctor will be able to find out which treatment they were given.
Where is the study run from?
University of Bristol (UK)
When is the study starting and how long is it expected to run for?
February 2013 to April 2014
Who is funding the study?
National Institute for Health Research (NIHR) (UK)
Who is the main contact?