title: Two days of dexamethasone versus 5 days of prednisone in the treatment of acute asthma: a randomized controlled trial.
abstract: OBJECTIVE
  Dexamethasone has a longer half-life than prednisone and is well tolerated orally. We compare the time needed to return to normal activity and the frequency of relapse after acute exacerbation in adults receiving either 5 days of prednisone or 2 days of dexamethasone.
  
  
  METHODS
  We randomized adult emergency department patients (aged 18 to 45 years) with acute exacerbations of asthma (peak expiratory flow rate less than 80% of ideal) to receive either 50 mg of daily oral prednisone for 5 days or 16 mg of daily oral dexamethasone for 2 days. Outcomes were assessed by telephone follow-up.
  
  
  RESULTS
  Ninety-six prednisone and 104 dexamethasone subjects completed the study regimen and follow-up. More patients in the dexamethasone group reported a return to normal activities within 3 days compared with the prednisone group (90% versus 80%; difference 10%; 95% confidence interval 0% to 20%; P=.049). Relapse was similar between groups (13% versus 11%; difference 2%; 95% confidence interval -7% to 11%, P=.67).
  
  
  CONCLUSIONS
  In acute exacerbations of asthma in adults, 2 days of oral dexamethasone is at least as effective as 5 days of oral prednisone in returning patients to their normal level of activity and preventing relapse.
authors.affiliation: Department of Emergency Medicine, Community Medical Center, St. Barnabas Health System, Toms River, NJ 08755, USA. joel_kravitz@hotmail.com
authors.forename: Joel
authors.initials: J
authors.lastname: Kravitz
authors.forename: Paul
authors.initials: P
authors.lastname: Dominici
authors.forename: Jacob
authors.initials: J
authors.lastname: Ufberg
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fisher
authors.forename: Patricia
authors.initials: P
authors.lastname: Giraldo
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents; D003907:Dexamethasone; D011241:Prednisone