Comparison of Oral Corticosteroid Doses in Asthma
Max Rubinstein
Benjamin A. Nelson
Adverse Behavioral Effects of Treatment for Acute Exacerbation of Asthma in Children: A Comparison of Two Doses of Oral Steroids
Kayani S, Shannon DC. Chest. 2002;122(2):624–628
Background
In the US in 2010–11, there were 15.5 million outpatient visits for asthma exacerbations and 1.5 million ED visits.1 Many of these patients are prescribed oral corticosteroids, with children receiving proportionally higher weight-based doses than adults, between 1–2 mg/kg/d. There was concern that higher doses could precipitate behavioral or psychiatric issues, but it was unknown whether these doses were necessary to adequately treat asthma exacerbations in children. This study sought to investigate the effects of varying oral corticosteroid doses.
Objectives
To determine the relative benefits and adverse effects of different doses of oral corticosteroids in children with mild asthma exacerbations.
Methods
Double-blind, randomized trial at a single US center.
Patients
86 outpatients ages 2 to 16 years with mild persistent asthma on inhaled corticosteroids evaluated for exacerbations (defined as cough, shortness of breath, or persistent wheeze after 3 consecutive albuterol treatments in 1 hour). Select exclusion criteria: oral corticosteroid therapy within 2 weeks of presentation, underlying attention deficit hyperactivity disorder, or psychiatric illness.
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