Respuesta a la Carta al Editor: Uso de corticoides sistémicos en exposiciones con sospecha de rabia

The publication ‘Use of antibiotics in patients who were attacked by animals that can transmit rabies’ is an observational study, with retrospective follow-up of a group of patients who had been bitten by animals. The patients were identified from a drug dispensing database, using the codes of the international classification of diseases, version 10, related to bites of animals that could potentially transmit rabies. A randomized and stratified sampling was carried out according to the country's geographical regions. The selected patients underwent a manual review of their medical records to identify sociodemographic, clinical and pharmacological variables of interest (Valladales-Restrepo et al., 2022). Therefore, the authors were not the treating physicians of the patients. Indeed, six patients received dexamethasone in their initial management. Glucocorticoids are not contemplated in the management of patients who have suffered animal bites (Stevens et al., 2014). In addition, this therapeutic group by various mechanisms increases the risk of bacterial, viral, and fungal infections, as soon as the first dose is administered and increases over time (Noetzlin et al., 2022). Thus, we agree with the comment made by Dr. Hasan Tahsin Gozdas, that these patients should not be managed with glucocorticoids due to the risk of superinfection.