Dexamethasone Versus Prednisone for Pediatric Acute Asthma Exacerbations: Specialists' Practice Patterns

Area of Science:

• Pediatric emergency medicine
• Pharmacotherapy
• Asthma management

Background:

• Dexamethasone offers potential advantages over prednisone for pediatric acute asthma exacerbations, including improved compliance, taste, and cost-effectiveness.
• Understanding current prescribing practices for dexamethasone versus prednisone in pediatric asthma is crucial for optimizing treatment guidelines.

Purpose of the Study:

• To determine the extent to which dexamethasone is prescribed for pediatric acute asthma exacerbations.
• To analyze variations in dexamethasone prescribing practices among different medical specialties.
• To identify common dosing regimens and frequencies for dexamethasone in pediatric asthma treatment.

Main Methods:

• A cross-sectional, descriptive study utilizing an anonymous, web-based survey.
• Survey targeted program directors in pediatric emergency medicine, pediatric pulmonology, allergy/immunology, and emergency medicine.
• Contact was made via email up to five times over three months to maximize response rates.

Main Results:

• A total of 300 program directors completed the survey, achieving response rates between 60% and 94% by specialty.
• One-third of providers reported using dexamethasone, while 51% continued to prescribe a 5-day course of prednisone.
• Pediatric emergency medicine directors showed a preference for dexamethasone (59%), whereas emergency medicine, pediatric pulmonology, and allergy/immunology directors favored prednisone.

Conclusions:

• Most academic pediatric emergency physicians have adopted dexamethasone for treating acute pediatric asthma exacerbations.
• Significant differences in prescribing preferences persist, with other specialties largely continuing to favor prednisone.