Single dose of dexamethasone as effective as a 5-day course of oral steroids for asthma exacerbations in children

Traditionally, mild-to-moderate pediatric asthma exacerbations have been treated with a short course of oral steroids - often 5 days of prednisone or prednisolone. According to a recent review from the journal Canadian Family Physician, a similar outcome can be acheived with a single dose of dexamethasone, which has a longer half-life and powerful anti-inflammatory effects, along with easier administration and compliance.

Oral administration of dexamethasone is the preferred route, especially considering the 80% bioavailability.

One study followed 110 children at 5 days after randomization to either a single dose of oral dexamethasone (0.6 mg/kg, maximum 18 mg) or oral prednisolone (1 mg/kg per dose, maximum 30 mg) twice daily for 5 days. Overall hospital admission rates at 5 days did not differ significantly between dexamethasone and prednisolone. Self-assessment scores returned to baseline in 5 days in both groups.

References:

Single-dose dexamethasone for mild-to-moderate asthma exacerbations: Effective, easy, and acceptable. Cross KP, Paul RI, Goldman RD. Can Fam Physician. 2011 Oct;57(10):1134-6.

Image source: Dexamethasone, Wikipedia.

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