Related Experiment Videos

Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma

F Qureshi1, A Zaritsky, M P Poirier

  • 1Department of Pediatrics and the Division of Pediatric Emergency Medicine, Children's Hospital of The Kings Daughters and Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.

The Journal of Pediatrics
|July 11, 2001
PubMed

Insights

Two days of dexamethasone (DEX) showed similar effectiveness to five days of prednisone (PRED) for treating acute pediatric asthma. DEX also improved compliance and reduced side effects in children with asthma.

Area of Science:

  • Pediatric Emergency Medicine
  • Pharmacology
  • Respiratory Medicine

Background:

  • Acute asthma exacerbations are common in children, often requiring systemic corticosteroid treatment.
  • Current treatment guidelines frequently involve extended courses of prednisone/prednisolone (PRED).
  • Shorter, potentially more effective treatment regimens are needed to improve outcomes and adherence.

Purpose of the Study:

  • To compare the efficacy of a 2-day course of oral dexamethasone (DEX) versus a 5-day course of oral prednisone/prednisolone (PRED) in children with acute asthma.
  • To evaluate symptom improvement and relapse prevention within 10 days of treatment.

Main Methods:

  • A prospective randomized trial involving children aged 2 to 18 years presenting with acute asthma.
  • Children received either PRED (2 mg/kg/day, max 60 mg) for 5 days or DEX (0.6 mg/kg, max 16 mg) for 2 days.
  • The primary outcome was relapse within 10 days post-discharge.

Main Results:

  • Relapse rates were similar between the DEX (7.4%) and PRED (6.9%) groups.
  • Hospitalization rates and symptom persistence at 10 days were comparable between both treatment arms.
  • The PRED group experienced significantly more vomiting, parental noncompliance, and missed school days compared to the DEX group.

Conclusions:

  • A 2-day course of oral dexamethasone is as effective as a 5-day course of prednisone/prednisolone for treating acute asthma in children.
  • Dexamethasone offers improved compliance and fewer adverse effects, including reduced vomiting and school absenteeism.
  • This shorter DEX regimen represents a viable alternative for managing pediatric acute asthma.
Abstract

Related Concept Videos

Antiasthma Drugs: β2-Adrenoceptor Agonists01:25

Antiasthma Drugs: β2-Adrenoceptor Agonists

Bronchodilators are critical in managing asthma, a chronic respiratory condition characterized by airway constriction due to inflammation and hyper-reactivity. Specifically, bronchodilators ease this constriction by relaxing the bronchial muscles, facilitating easier breathing.
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce relaxation in these...
Antiasthma Drugs: Methylxanthines01:24

Antiasthma Drugs: Methylxanthines

Theophylline, a member of the methylxanthine class of bronchodilators, has long been used in asthma management. While its exact mechanism of action is not fully understood, it is believed to have multiple effects on various cellular processes.
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs01:25

Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs

Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Inhaled Medications01:23

Inhaled Medications

Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...