Post-natal corticosteroid use.
Corticosteroids given systemically in the first 2 weeks after birth may reduce chronic lung disease (CLD) and mortality, but there are concerns regarding the long-term adverse effects which may have influenced prescribing habits. The aim of this study was to determine whether corticosteroids were still prescribed and, if so, was there a consensus regarding the most appropriate regimen to use. Consultant paediatricians at all 223 neonatal units in the United Kingdom were sent a questionnaire asking which route, timing, dosage and indications they used when administering corticosteroids. There was a 72% response rate to the survey. Of those who responded, 33% never prescribed steroids and 3.75% gave inhaled steroids only. Corticosteroids were not prescribed in the 1st week after birth, 21.1% of respondents commenced administration in the 2nd week and 33.3% only outside the neonatal period. A total of 48% prescribed a daily dose of 0.5 mg/kg per day, 33% gave lower doses, with 7.9% prescribing 0.1 mg/kg per day or less. The majority (77%) prescribed corticosteroids only to ventilator-dependent infants, others also gave corticosteroids to chronically continuous positive airway pressure- or oxygen-dependent infants.


CONCLUSIONS
There are wide variations in corticosteroid usage. This emphasises the need to identify if there is a corticosteroid dosage regimen with a positive risk/benefit ratio.
Williams
Olivia
O
Children Nationwide Regional Neonatal Intensive Care Unit, Department of Child Health, Kings College Hospital, SE5 9RS London, UK.
Greenough
Anne
A
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007229:Infant Welfare; D007231:Infant, Newborn; D008171:Lung Diseases / Q000188:drug therapy / Q000453:epidemiology; D011181:Postnatal Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000305:Adrenal Cortex Hormones