Steroids and antibiotics for treatment of acute asthma exacerbations in African-American children.
BACKGROUND
There has been great debate surrounding the appropriate treatment regimens in children who present with acute asthma exacerbations secondary to upper respiratory tract infections.


OBJECTIVE
To determine whether treatment with corticosteroids alone or in combination with antibiotics will decrease respiratory symptoms in children who develop asthma exacerbations secondary to upper respiratory tract infections.


METHODS
A retrospective cohort control study involving 86 African-American children, ages 5-16, with mild intermittent asthma. The patients were treated with an albuterol inhaler (control group), inhaler plus five days of Prednisone; or inhaler, Prednisone, and 10 days of Amoxicillin. All patients were assessed regarding peak flows, albuterol inhaler usage, and symptomatology.


RESULTS
On follow up five- to seven days after presentation, the corticosteroids group demonstrated a marked improvement in peak flows (88% versus 77%) and a significantly lower albuterol inhaler usage rate (2.2 versus 3.7 times a day) relative to the control group. The corticosteroids plus antibiotics group demonstrated peak flows (86% versus 88%) and inhaler usage (2.4 versus 2.2) nearly identical to corticosteroids alone, but the severity of underlying respiratory symptoms was significantly less.


CONCLUSIONS
A five-day course of oral corticosteroids will significantly improve lung function and lessen severity of asthma symptoms. The addition of antibiotics to the treatment regimen has no additive effect on the reactive airway symptoms.
Rodrigues
Rui G
RG
Penn State Milton S. Hershey Medical Center, Department of Pediatrics, H085, 500 University Drive, P.O. Box 850, Hershey, PA 17033-0850, USA. rrodrigues@psu.edu
D000293:Adolescent; D001741:Black or African American; D000420:Albuterol / Q000627:therapeutic use; D000658:Amoxicillin / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D000658:Amoxicillin; D000420:Albuterol; D011241:Prednisone