A randomized trial of two dexamethasone regimens to reduce side-effects in infants treated for chronic lung disease of prematurity.
OBJECTIVE
Dexamethasone has been widely used to reduce the incidence of chronic lung disease in preterm infants. However side-effects are common, and the ideal dose of dexamethasone has not been identified. We aimed to determine whether an individualized course of dexamethasone given to preterm babies at risk of chronic lung disease reduced the total dose of dexamethasone administered and reduced side-effects compared with a standard 42-day course.


METHODS
Thirty-three infants in a regional neonatal unit with a birthweight of < or =1250 g who required mechanical ventilation at 7 days of age were randomly assigned to a 42-day course of dexamethasone or an individualized course tailored to their respiratory status. The primary outcome was linear growth at 36 weeks corrected gestational age.


RESULTS
Infants in the individualized course received a 40% lower total dose of dexamethasone. However, there was no difference between the two groups in linear growth or in the incidence of any other side-effects of treatment. There was also no difference in respiratory status or neurodevelopmental outcome.


CONCLUSIONS
The individualized course of dexamethasone used in this study reduced the total dose of dexamethasone administered but did not significantly reduce side-effects of treatment or alter outcome in infants at risk of chronic lung disease.
Odd
D E
DE
Newborn Services, Department of Paediatrics, University of Auckland, Auckland, New Zealand.
Armstrong
D L
DL
Teele
R L
RL
Kuschel
C A
CA
Harding
J E
JE
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002908:Chronic Disease; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006128:Growth / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007677:Kidney Function Tests; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D008991:Monitoring, Physiologic; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone