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Oral prednisone as a risk factor for infections in children with asthma
C C Grant1, A K Duggan, M Santosham
1Division of General Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
Short courses of prednisone for childhood asthma attacks do not increase the frequency of acute infections. This study found no link between prednisone doses and infection rates in children with asthma.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Asthma is a common chronic respiratory condition in children, often requiring treatment with corticosteroids like prednisone for acute exacerbations.
- Concerns exist regarding potential immunosuppressive effects of systemic corticosteroids, possibly increasing susceptibility to infections.
Purpose of the Study:
- To investigate the association between the number of prednisone doses administered for acute asthma attacks and the frequency of subsequent acute infections in children.
- To determine if short-term prednisone use for asthma exacerbations elevates the risk of common infections in pediatric patients.
Main Methods:
- A cohort study design was employed, enrolling 86 children aged 2 to 14 years with a history of recurrent acute asthma.
- Data were collected from a primary care clinic and emergency department over a 14-month period.
- The primary outcome measured was the number of acute infection episodes, correlated with the cumulative prednisone dose received during the study.
Main Results:
- A total of 94 acute infection episodes occurred in 50 children during the study period.
- No statistically significant difference was found in the mean number of prednisone doses received by children who experienced infections compared to those who did not.
- There was no observed correlation between the total number of prednisone doses and the incidence of specific infections.
Conclusions:
- Short-term administration of prednisone for managing acute asthma attacks in children is not associated with an increased frequency of common acute infections.
- These findings suggest that the benefits of short-course prednisone for asthma exacerbations outweigh potential risks of increased infection in this pediatric population.
Objective:
To determine whether the frequency of acute infections in children with asthma is associated with the number of doses of prednisone received for asthma attacks.
Design:
A cohort study.
Setting:
Primary care clinic and emergency department of an inner-city teaching hospital from March 31, 1992, to May 31, 1993.
Patients:
Convenience sample of clinic enrollees aged 2 to 14 years who had made two or more outpatient visits for acute asthma in the preceding year. Eighty-six children were enrolled. Seventy-eight (91%) completed the study.
Main Outcome Measures:
The independent variable was cumulative prednisone dose received during the study period. Outcome variables were episodes of acute infections.
Results:
The mean (+/-SD) number of doses of prednisone (2 mg/kg to a maximum of 60 mg) received was 9.5 +/- 11.8 doses (range, 0 to 57 doses). Ninety-four episodes of acute infection occurred in 50 children. No difference was observed in the mean number of doses of prednisone received by those with the infection compared with those without the infection. No correlation was observed between the number of doses of prednisone received and the number of episodes of each infection.
Conclusions:
The administration of prednisone as short courses for acute asthma is not associated with an increase in the number of episodes of common acute infections.