title: Effects of prednisolone and dexamethasone in children with alkali burns of the oesophagus.
abstract: We compared the efficacies of prednisolone and dexamethasone for treatment of children with oesophageal burns due to ingestion of caustic substances. The criteria of efficacy used were a) stricture severity by 3 weeks post-ingestion, b) reduction in burn severity by 3 weeks post-ingestion and c) number of dilatations required over the first year post-ingestion. Thirty-six children (24 boys and 12 girls; mean age 23.6 +/- 7.4 months) were selected from a total of 63 patients admitted over a ten-year period to the General Hospital of Galicia with second- or third-degree oesophageal burns due to accidental ingestion of liquid alkali preparations. The patients were divided into two groups of 18, one group for treatment with prednisolone (2 mg/kg/day) and the other for treatment with dexamethasone (1 mg/kg/day). Strictures developed in 12 (66.7%) of the children in the prednisolone-treated group and only 7 (38.9%) of the children in the dexamethasone-treated group. Severe strictures developed in 10 (55.6%) of the children in the prednisolone-treated group and only 5 (27.8%) of the children in the dexamethasone treated group. However, there was no significant difference between the groups in the posttreatment distribution of stricture-severity ratings. Burn healing was significantly better in the dexamethasone-treated group. Similarly, the number of dilatations necessary during the first year of treatment was significantly lower in the dexamethasone-treated group. Our results thus indicate that, by comparison with prednisolone, dexamethasone leads to improved burn healing and reduced need for dialatations during the first year post-injury.
authors.affiliation: Paediatrics Department, General Hospital of Galicia, University of Santiago, Sergas, La Coruña, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bautista
authors.forename: R
authors.initials: R
authors.lastname: Varela
authors.forename: A
authors.initials: A
authors.lastname: Villanueva
authors.forename: E
authors.initials: E
authors.lastname: Estevez
authors.forename: R
authors.initials: R
authors.lastname: Tojo
authors.forename: S
authors.initials: S
authors.lastname: Cadranel
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002057:Burns, Chemical / Q000145:classification / Q000188:drug therapy*; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use*; D004106:Dilatation; D004940:Esophageal Stenosis / Q000517:prevention & control / Q000628:therapy; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use*; D011859:Radiography
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D011239:Prednisolone