When do you consider the use of steroids in the management of acute exacerbations in patients with cystic fibrosis?

Steroids have been shown to improve FEV1 and decrease hospitalizations when used as a maintenance treatment regimen in Cystic fibrosis patients. But due to the long-term adverse effects, steroids are recommended for daily use (Mogayzel et al., PMID 23540878).

Small Pilot projects showed no statistica...

My approach is not overly scientific in this situation, as we do not have enough data; I make sure there are no signs of systemic sepsis, or persistent fever first and no reason to avoid steroids (like acute COVID); I tend to utilize low doses if there are signs of asthmatic exacerbation, like a lot...

Two recent publications may help with this question.

The PIPE study randomized patients in a double-blind fashion to receive oral prednisone at a dose of 1 mg/kg twice daily (max 60 mg daily) at D7 of treatment with IV antibiotics if ppFEV1 failed to return to 90% of baseline. The duration of treatme...