Oral Dexamethasone vs Oral Prednisone for Children With Acute Asthma Exacerbations: A Systematic Review and Meta-Analysis

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Categorical data were summarized using the Mantel-Haenszel Risk Ratio with 95% confidence intervals . I2 values of 25–50% represented low, values of 50–75% medium and more than 75% represented substantial heterogeneity. A sensitivity analysis was carried out to assess the influence of each study on the pooled effect size. Sub-group analysis was conducted for relapse rates based on follow-up period (1–5 days or 10–15 days) and dosage of dexamethasone. Using the method described by Muncer et al. , power of included studies for the every variable was calculated.

Relapse after prednisone therapy has been attributed to several factors like the unpleasant bitter taste of the drug, side-effects like vomiting, and its multi-dose regimen of 3–5 days which may reduce patient compliance (8–10). It is also not known if both drugs are equally efficacious in reducing asthma severity. Our results however indicate that, vomiting is significantly less with dexamethasone as compared to prednisone.

Paediatric patients are recommended to be given a 6mg dose (1.8ml) IV once a day for up to 10 days. Intravenous or intramuscular injections are advised in acute illness. When the acute stage has passed, oral steroid therapy should be substituted as soon as feasible. In emergencies, the usual dose of Dexamethasone 3.3 mg/ml solution for injection by intravenous or intramuscular injection is 3.3 mg – 16.6 mg (1.0 ml – 5.0 ml) - in shock use only the i.v. To avoid hypoadrenalism and/or a relapse of the underlying disease, it may be necessary to withdraw the drug gradually (see 'Special warnings and precautions for use').

Steroid tablets that are taken for a short period of time are unlikely to cause side effects. Please take time to read the patient information leaflet that comes with your medicine. There's no evidence to suggest that using a steroid inhaler during pregnancy increases the risk of problems like birth defects.

If you’re worried about this, talk to the person who is prescribing your steroids about it. The person treating you will make sure you’re on the lowest possible dose to keep your condition under control. You might also be given a drug called a proton pump inhibitor or another medicine to protect your stomach.

Alternatively, it can be added, without loss of potency, to sodium chloride, or dextrose, injection and given by intravenous infusion. Catching chickenpox can cause you to become really unwell if you’re taking steroids. Is ongoing into new treatments for all types of severe asthma. Their metabolism to inactive forms is almost complete during the first pass through the liver, so in theory, systemic side effects should be negligible .

Some studies have shown that women taking a systemic corticosteroid in pregnancy may have a higher chance of miscarriage or preterm delivery. However, this is thought to be at least partly explained by the fact that some of the health conditions that systemic corticosteroids are used to treat have themselves been linked to a higher chance of these pregnancy outcomes. Overall, there is no convincing evidence that corticosteroid use in pregnancy directly causes miscarriage or preterm delivery.

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. Patients already receiving Red Medicines in primary care should be handled on a case by case basis with the support of the Medicines Optimisation team. If steroids are taken twice daily, an alternative approach to monitoring and subsequent treatment will be required. In dying patients it is usually appropriate to discontinue corticosteroids. However, all cases should be assessed individually and it may be beneficial to continue to achieve symptom control.

3mg/ml) assuming 4mg of oral dexamethasone is approximately equivalent to 3. Dexamethasone tablets are formulated as dexamethasone base; the oral solution, soluble tablets and injectable formulations are formulated as dexamethasone sodium phosphate. The British National Formulary , Summaries of Product Characteristics and product labels now all use dexamethasone base for labelling and dosing advice.