To examine the association between exposure to oral corticosteroid bursts with severe adverse medical events.

A retrospective cohort was derived from the National Health Insurance Research Database in Taiwan of children (<18 years old) from 2013–2017.

By using a national database of medical claims and prescription data, a self-controlled case series was used to compare risks in a pretreatment period before corticosteroid exposure (5–90 days) and 2 posttreatment periods (5–30 days and 31–90 days). The primary outcomes were the incidence rate ratios per 1000 person-years for gastrointestinal bleeding, sepsis, pneumonia, and glaucoma after oral corticosteroid burst exposure among children who did or did not receive the oral corticosteroid bursts. Exposure to corticosteroid burst was defined as a prescription record of oral corticosteroids for ≤14 days. A conditional fixed-effect Poisson regression model was used.

The study sample included 4 542 623 children of which 42% received at least 1 oral corticosteroid...

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