Dexamethasone Compared to Prednisone for the Treatment of Children With Acute Asthma Exacerbations
| Autor: | Ruth Abaya, Laura Jones, Joseph J. Zorc |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Administration Oral Injections Intramuscular Dexamethasone 03 medical and health sciences 0302 clinical medicine Oral administration Prednisone 030225 pediatrics Acute care Internal medicine Humans Medicine 030212 general & internal medicine Child Adverse effect Glucocorticoids Asthma business.industry General Medicine Emergency department medicine.disease humanities Regimen Pediatrics Perinatology and Child Health Emergency Medicine business medicine.drug |
| Zdroj: | Pediatric Emergency Care. 34:53-58 |
| ISSN: | 0749-5161 |
| Popis: | Systemic corticosteroids are recommended in clinical practice guidelines for the treatment of acute asthma exacerbation based on evidence demonstrating reduced hospitalizations and improved outcomes after administration in the emergency department. Although prednisone and related oral preparations have been recommended previously, researchers have assessed dexamethasone as an alternative based on its longer biologic half-life and improved palatability. Systematic reviews of multiple small trials and 2 larger trials have found no difference in revisits to the emergency department compared to prednisone for dexamethasone given either as an intramuscular injection or orally. Studies of oral administration have found reduced emesis for dexamethasone compared to prednisone both in the emergency department and for a second oral dose, typically given 24 to 48 hours later. Studies assessing a single dose of dexamethasone have found equivalent improvement at follow-up but with some evidence of increased symptoms and increased need for additional corticosteroids compared to multiple doses of prednisone. Future research could further assess dexamethasone dose, formulation, and frequency and measure other related adverse effects such as behavior change. Consideration of baseline differences within the heterogeneous population of children requiring acute care for asthma may also guide the design of an optimal dexamethasone regimen. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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