Abstract

The introduction of inhaled corticosteroids (ICS) for the management of asthma hasled to a decrease in acute exacerbation of asthma. However, there are concerns regardingthe safety of long-term ICS use, particularly pneumonia. Growing evidenceindicates that ICS use is associated with an increased risk of pneumonia in patientswith chronic obstructive pulmonary disease, whereas the risk in patients with asthmaremains unclear. This review discusses the effect of ICS on pneumonia among patientswith asthma to update the existing literature. Asthma is associated with an increasedrisk of pneumonia. Several hypotheses have been proposed to explain this association,including that asthma impairs the clearance of bacteria owing to chronic inflammation. Therefore, controlling airway inflammation with ICS may prevent the occurrence ofpneumonia in asthma. In addition, two meta-analyses investigating randomized controltrials showed that ICS use was associated with a protective effect against pneumoniain asthma.