Table 1

Steroid regimen for children with CNS tumours

Indications (i) Raised ICP (i) Allergic reactions
(ii) Preparation for neurosurgery  Prevention
(iii) Antiemetic  Treatment
(ii) Anaphylaxis
Drug DexamethasoneHydrocortisone
Route Oral, intravenousIntravenous
Starting dose 5-10 mg/m2/day in divided dosesOR4 mg/kg bolus
0.5 mg/kg/day in divided doses
Maximum 16 mg/day200 mg bolus
Notes Smaller doses if possible2 mg/kg 6 hourly if needed
Trial of 3-5 day courses for raised ICPOnly use if chlorpheniramine inadequate, or anaphylaxis
Only use as antiemetic if other drugs not effective
  • All patients prescribed steroids receive concurrent oral nystatin and an antacid (magnesium trisilicate preparation).