The Evidence for and Against Corticosteroid Prophylaxis in At-Risk Patients.

Matthew S Davenport, Richard H Cohan

Journal: Radiologic clinics of North America 2017;55(2):413-421

PMID: 28126223

Full Text on Elsevier Science View on PubMed

Abstract

Corticosteroid prophylaxis is commonly used for the prevention of allergiclike reactions to iodinated and gadolinium-based contrast material in patients at highest risk of an allergiclike reaction. However, it has only a weak mitigating effect on allergiclike reactions, probably does not affect the severity of subsequent reactions, and does not prevent all reactions. Breakthrough reactions occur, are usually the same severity as the index reaction, and can occasionally be life threatening. Premedication of inpatients is likely associated with substantial cost and harm because of hospital length-of-stay prolongation; these indirect effects may exceed the benefits of premedication in this population.

Address: Department of Radiology and Urology, Michigan Radiology Quality Collaborative, University of Michigan Health System, 1500 East Medical Center Drive, B2-A209P, Ann Arbor, MI 48109, USA. Electronic address: [email protected].; Department of Radiology, University of Michigan Health System, 1500 East Medical Center Drive, B2-A209P, Ann Arbor, MI 48109, USA.

DOI: 10.1016/j.rcl.2016.10.012

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MeSH Terms: Adrenal Cortex Hormones, Contrast Media, Drug Hypersensitivity, Gadolinium, Humans, Iodine, Premedication, Risk Factors