title: A comparison of oral dexamethasone with oral prednisone in pediatric asthma exacerbations treated in the emergency department.
abstract: 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.
authors.affiliation: 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
authors.forename: Richard A
authors.initials: RA
authors.lastname: Greenberg
authors.forename: Gwen
authors.initials: G
authors.lastname: Kerby
authors.forename: Genie E
authors.initials: GE
authors.lastname: Roosevelt
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D011241:Prednisone / Q000008:administration & dosage*; D011446:Prospective Studies; D012008:Recurrence; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D011241:Prednisone