Effectiveness of corticosteroid in the treatment of dengue – A systemic review

Corticosteroids are used therapeutically for a broad spectrum of diseases including autoimmune, allergic and inflammatory diseases. However in trials, the evidence for using corticosteroids in dengue is inconclusive and the quality of evidence is low. This systemic review is conducted to review clinical trials on dengue and steroid therapy to identify the current strength and weakness of evidence for the use of corticosteroids. We searched MEDLINE/PUBMED and Google scholar for publications on steroid use in dengue and the relevant authors of the study were contacted for additional information, as required. This review includes thirteen studies enrolling 1293 children and adult participants. There was no evidence of viremia and no significant side effects after the administration of low and high doses of oral corticosteroids and high doses of intravenous corticosteroids. Beneficial therapeutic effects were seen in some studies, which used high doses or multiple doses of steroids. The effectiveness of corticosteroids in dengue is depended upon sustained therapeutic blood levels of corticosteroids for an adequate duration and using a steroid with higher receptor affinity. Further clinical trials using pharmacologically and immunologically accepted standard steroid protocols are warranted to validate this conclusion.