Use of Nebulized Corticosteroids Beyond Asthma and Chronic Obstructive Pulmonary Disease (COPD): A Scoping Review of Off-Label Respiratory and Perioperative Applications.

Current literature suggests the potential benefits of nebulized corticosteroids (NCs), particularly budesonide and fluticasone, in the treatment of various respiratory conditions beyond their conventional application. This review aimed to comprehensively summarize the available evidence regarding the use of NCs for medical conditions beyond their conventional role in asthma and chronic obstructive pulmonary disease (COPD) management. This scoping review included all studies evaluating the use of NCs in children and adults for indications other than asthma and COPD. The search was limited to human studies published in English. Data were collected from the PubMed and Cochrane databases through December 2025. A narrative approach was employed to synthesize the extracted data, which are summarized and presented in tables and graphs. As this was a scoping review, formal risk of bias assessment and certainty of evidence evaluation were not performed. A predefined methodological approach was followed; however, no formal protocol registration was undertaken. A total of 302 articles were identified from various databases, of which 36 met the inclusion criteria. The included studies enrolled a total of 3,415 patients (range: 20-525) and primarily comprised randomized controlled trials, including double-blind placebo-controlled studies, prospective randomized studies, multicenter trials, pilot studies, and comparative interventional studies. Several indications beyond the conventional use of NCs in asthma/COPD were identified, including bronchiolitis, transient tachypnea of the newborn, respiratory complications after endotracheal intubation, croup, meconium aspiration syndrome, chronic rhinosinusitis, and viral wheezing. Overall, the available literature suggests that NCs may have therapeutic applications beyond asthma and COPD; however, the available evidence was heterogeneous with respect to indications, patient populations, study designs, and outcome measures. Further research is needed to clarify the effectiveness and safety of NCs, enabling evidence-based decision-making and improving patient-related outcomes.