Lightning Learning: Steroids in Asthma
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.
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
Oral ➔ 0.6 mg/kg (maximum of 16 mg/dose) (3)
- Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma (F. Qureshi et al.)
- Dexamethasone for acute asthma exacerbations in children: a meta-analysis (G.E. Keeney et al.)
- Management of Wheeze and Asthma in Children (Local Paediatric ED guideline)