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You are asked to see a 6-year-old child who has come into hospital with an acute exacerbation of asthma. She is able to talk in full sentences, however, her respirations are 40/min with audible wheeze, and you prescribe 10 puffs of salbutamol as initial management. The British Thoracic Society (BTS) guidelines recommend early use of steroids to decrease admission rate and length of stay,1 and you feel steroids would be of value for this child. However the mother of your patient explains her daughter hates taking any medications. You have read an article about dexamethasone being a shorter treatment course with better compliance and wonder if it has similar efficacy to prednisolone.
In children who have an acute exacerbation of asthma requiring steroids (population), does dexamethasone (intervention) have similar efficacy to prednisolone (comparison) in achieving decreased airway inflammation, decreased admission rates and length of hospital stay (outcome)?
Search strategy and outcome
Medline (1996 to September week 2 2012) and Embase (1996 to 20 September 2012) were searched via Ovid on 21 September 2012 using the search terms ((dexamethasone AND prednisolone) or (dexamethasone AND prednisone)) AND ((acute asthma) OR (asthma exacerbation)). A total of 82 abstracts were reviewed, and six relevant studies were found: five papers were identified after review of …