Dose-Response Relationship Between Glucocorticoids and S. aureus Bacteremia Risk

HealthDay News –  Data from a population-based case control study found that systemic glucocorticoid use was associated with increased risk of Staphylococcus aureus bacteremia (CA-SAB), with a clear dose-response relationship.  In the population studied, patients taking glucocorticoids for an extended period of time with connective tissue disease and chronic lung disease had the most pronounced risk of CA-SAB. These findings were published in Mayo Clinic Proceedings.

Jesper Smit, MD, of Aarhus University Hospital in Denmark, and colleagues reviewed the medical records of 29,017 patients in Denmark and found that those who used systemic glucocorticoids were 2.5 times more likely than non-users to develop CA-SAB (adjusted odds ratio, 2.48).

High Yield Data Summary

  • Glucocorticoids are associated with an increased risk of CA-SAB
  • For long-term users, risk was most pronounced in patients with connective tissue disease and chronic pulmonary disease

The researchers also found that CA-SAB risk rose along with the dose of the medicines given. Compared to non-users, those with a 90-day cumulative corticosteroid dose less than or equal to 150 mg had 2.42 times higher risk, but the risk was as high as 6.25 times greater for patients with a cumulative dose of more than 1,000 mg. 

Among patients with connective tissue disease or chronic lung disease, the risk of CA-SAB was highest in long-term glucocorticoid users. Among cancer patients, the risk was highest for new users of the drugs.

The findings are “a reminder for clinicians to weigh carefully the elevated risk against the potential beneficial effect of glucocorticoid therapy,” Dr Smit said in a Mayo news release.


Smit J, Kaasch A, Søgaard M, et al. Use of Glucocorticoids and Risk of Community-Acquired Staphylococcus aureus Bacteremia: A Population-Based Case-Control Study. Mayo Clin Proc. 2016; Epub ahead of print June 8, 2016. doi 10.1016/j.mayocp.2016.04.023

Related Articles