Can tuberculosis patients use glucocorticoids?

Glucocorticoids generally are not recommended for patients with tuberculosis. However, they may be considered when tuberculosis presents with severe toxic symptoms or is accompanied by other serious conditions. If any abnormalities occur, timely medical consultation is advised. Detailed analysis is as follows:

In most cases, glucocorticoids are contraindicated in patients with tuberculosis. Glucocorticoids may lead to recurrence or worsening of tuberculosis. Additionally, patients with concurrent active peptic ulcer disease, severe hypertension and arteriosclerosis, diabetes, or other conditions should also avoid the use of glucocorticoids to prevent exacerbation of the disease or the occurrence of other severe complications.

However, if a patient with tuberculosis presents with very severe tuberculous toxic symptoms, glucocorticoids may be used under medical guidance. For example, in cases of acute miliary tuberculosis, or when tuberculosis is accompanied by severe symptoms such as high fever, dyspnea, pericardial effusion, or when the patient is allergic to anti-tuberculosis drugs or in an immunosuppressive state, glucocorticoid use under medical supervision may rapidly alleviate symptoms, provide time for anti-tuberculosis treatment, or partially restore immune function and improve treatment outcomes. However, glucocorticoid use must be accompanied by effective anti-tuberculosis drug therapy, and the dosage and duration of treatment must be strictly controlled to avoid long-term or excessive administration.

When using glucocorticoids, it is essential strictly to follow medical instructions; self-adjusting the dosage or discontinuing the medication is not advised. During treatment, the patient's condition should be closely monitored, and medical attention should be sought promptly if any adverse reactions occur.