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A corticosteroid program for prevention of hospitalization for status asthmaticus in children
Insights
Short-term prednisone treatment effectively prevents asthma hospitalizations in children. This approach benefits both privately insured and uninsured patients, reducing the need for emergency care for acute asthma exacerbations.
Area of Science:
- Pediatrics
- Pulmonology
- Pharmacology
Background:
- Acute asthma exacerbations in children often require hospitalization.
- Bronchodilators and inhaled corticosteroids/cromolyn may not fully control severe asthma attacks.
- Prednisone is a corticosteroid used to reduce inflammation in asthma.
Purpose of the Study:
- To evaluate the effectiveness of an outpatient prednisone course in preventing hospitalization for status asthmaticus in children with acute asthma.
- To compare the efficacy of prednisone treatment in privately insured versus non-privately insured children.
Main Methods:
- A prospective study involving 181 children with acute asthma exacerbations inadequately controlled by standard treatments.
- Children received a five-day course of prednisone at 1 mg/kg/day (max 40 mg/day).
- Hospitalization rates for status asthmaticus were recorded and analyzed based on insurance status.
Main Results:
- Only 10 out of 181 children required hospitalization for status asthmaticus.
- Hospitalization rates were similar between privately insured (5/61) and non-privately insured (5/120) groups.
- Prednisone treatment significantly reduced the need for hospitalization.
Conclusions:
- Short-term oral prednisone is a valuable outpatient treatment for acute asthma exacerbations in children.
- This intervention effectively decreases hospitalization rates for status asthmaticus.
- Prednisone therapy is equally effective in children with and without private hospitalization insurance.
Abstract:
This study assessed the efficacy of an outpatient course of prednisone in the treatment of acute asthma, as a method of preventing hospitalization for status asthmaticus. From September-November 1984, 181 courses of prednisone were utilized by children for acute exacerbations of asthma inadequately controlled by bronchodilators and inhaled beclomethasone dipropionate or cromolyn. The dose of prednisone was 1 mg/kg/day for five days with a maximum of 40 mg/day. Only ten children required hospitalization for status asthmaticus. Privately insured patients and non-privately insured patients accounted for 61 and 120 of the prednisone courses, respectively, of which five children from each group required hospitalization. The data suggest that short-term administration of prednisone for exacerbations of asthma was valuable in decreasing the need for hospitalization for asthma among bronchodilator-treated asthmatics. Further, patients from families without private hospitalization insurance appear as amenable to prednisone-intervention as privately insured patients.