The use of glucocorticoid in hand-foot-mouth disease / 中国小儿急救医学

No established antiviral treatment is available for hand-foot-mouth disease recently.Glucocorticoid treatment for severe hand-foot-mouth disease is controversial.Questions about the indication,dosage and course of treatment are still being explored.The indication and efficacy of glucocorticoid are lacked of support of evidence-based medicine.

Use of glucocorticoid in severe hand-foot-mouth disease and the therapeutic effects of different dose of glucocorticoid in Henan and Sichuan Province / 中华实用儿科临床杂志

Objective To investigate the use of glucocorticoid in severe hand-foot-mouth disease in Henan and Sichuan Province and to compare the therapeutic effects of different dose of glucocorticoid.Methods In this multicenter retrospective study,320 cases of severe hand-foot-mouth disease,which were randomly sampled from Jan.to May 2011 in Henan and Sichuan Province were collected.The use of intravenous glucocorticoid was calculated.Accor-ding to the dose of corticosteroids which had been used,these cases were divided into 3 groups:the non-corticosteroids group,the low-dose group and the high-dose group.The cure rate,febrile duration,nervous system involvement duration,time of staying in hospital,vital signs and serum glucose in 3 groups were compared.Results Patients who used intravenous glucocorticoid accounted for 90.9％ (291/320 cases),and only 29 patients had not used (9.1％).The cure rate among 3 groups were not significantly different(P ＞0.05).In the low-dose group and the high-dose group,the nervous system involvement duration,the febrile duration and time of staying in hospital were longer than those in the non-corticosteroids group (all P ＜ 0.05).Comparing the blood pressure among 3 groups on the first day and the third day of hospitalization,the diastolic blood pressure in the high-dose group was much higher than that in other 2 groups on the third day of hospitalization(all P ＜ 0.05).Conclusions Glucocorticoid is generally used in severe hand-foot-mouth disease in Henan and Sichuan Province.The high-dose glucocorticoid is more often used in the situation that fever,nervous system involvement are not relieved.Glucocorticoid can never improve the cure rate in patients with severe hand-foot-mouth disease or shorten the course,relieve clinical symptoms.The therapeutic effects of glucocorticoid in severe hand-footmouth disease are not confirmed.The therapy of high-dose glucocorticoid may increase medicinal side effects.