A comparison of oral dexamethasone with oral prednisone in pediatric asthma exacerbations treated in the emergency department.

Author(s): Greenberg RA, Kerby G, Roosevelt GE

Affiliation(s): Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84158, USA. richard.greenberg@hsc.utah.edu

Publication date & source: 2008-10, Clin Pediatr (Phila)., 47(8):817-23. Epub 2008 May 8.

Publication type: Comparative Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural

The aim of this study was to determine if 2 doses of oral dexamethasone are as effective as a 5-day course of oral prednisone in preventing relapse for pediatric asthma exacerbations. Patients presenting to the emergency department with an asthma exacerbation were randomized to receive 0.6 mg/kg of dexamethasone or 2 mg/kg of prednisone in a prospective, double-blind study. The primary outcome was relapse within 10 days, and the secondary outcome was vomiting in the emergency department. Eighty-nine patients completed the study: 38 in the prednisone group and 51 in the dexamethasone group. In all, 3 patients in the prednisone group (8%) and 8 patients in the dexamethasone group (16%) required an unscheduled follow-up visit (P = .27). In all, 7 patients in the prednisone group (18%) and 5 patients in the dexamethasone group (10%) had vomiting ( P = .24). No difference was found in the relapse rate or incidence of vomiting between patients given prednisone and dexamethasone for pediatric asthma exacerbations.