Should you give steroids during an infection?

Traditional teaching suggests that corticosteroids should be avoided during acute infectious episodes for fear of compromising the immune response. In addition, there are well-known adverse consequences of steroid use, including the possibility of masking the clinical course (by virtue of their positive anti-inflammatory effect, delaying adequate therapy for unrecognized deterioration), as well as the possibility of immunosuppression, a concern when using steroids in the treatment of infectious diseases. The first consideration is the biological plausibility of the use of steroids as an adjuvant in any infectious disease and the clinical models that exist to suggest that steroids may be beneficial. Any adverse consequences of long-term or chronic steroid use are no cause for concern because steroid use is only short-term.