Lightning Learning: Steroids in Asthma

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STOP!

The UK has some of the highest rates of asthma in the world affecting about one in ten children. In 2018 there were 25,128 cases of under-16s going to hospital with asthma. (NHS England)

• Steroids are used to reduce acute exacerbation, severity and duration.
• Treatment options include a short course of oral corticosteroid (typically 3 days of oral prednisolone).
• Data suggests that the use of oral dexamethasone is non-inferior compared to oral prednisolone.⁽¹⁾
• Consider a single dose of oral dexamethasone for acute asthma exacerbation in children.

LOOK

There is increased evidence of vomiting with prednisolone.⁽²⁾

With the use of dexamethasone we can reduce…

• The incidence of children vomiting at home and ED
• Non-compliance at home
• TTO dispensing

LEARN

Dexamethasone dose:

Oral ➔ 0.6 mg/kg (maximum of 16 mg/dose) ⁽³⁾

References:

1. Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma (F. Qureshi et al.)
2. Dexamethasone for acute asthma exacerbations in children: a meta-analysis (G.E. Keeney et al.)
3. Management of Wheeze and Asthma in Children (Local Paediatric ED guideline)