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EMERGENCY ORAL PREDNISONE REDUCES ASTHMA ADMISSIONS IN CHILDREN.

Parenteral steroids reduce hospitalizations for acute asthma when given in the emergency department. This study shows that oral prednisone is also effective.

Researchers randomized 36 children with moderately severe asthma to take oral prednisone (2 mg/kg) and 39 children to take placebo within 5 minutes after receiving a single nebulized albuterol treatment. Thirty minutes after the first nebulization, the two groups received identical regimens of frequent aerosolized albuterol. The groups were clinically and demographically comparable.

After 4 hours, a clinician blinded to the treatment assignment decided whether to hospitalize each child. Thirty-one percent of the prednisone-treated children required admission, versus 49 percent of the placebo group, a nonsignificant difference. However, the difference did reach significance among the 40 most severe asthmatics (32 percent with prednisone vs. 72 percent with placebo).

Comment: Perhaps even more admissions could have been averted had these children been monitored for more than 4 hours in the emergency department. Now, a head-to-head contest between oral and parenteral corticosteroids is needed.

— RAD

Published in Journal Watch General Medicine October 22, 1993

Citation(s):

Scarfone RJ et al. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics 1993 Oct 92 513-518.

• Medline abstract (Free)