Dexamethasone versus Prednisone/Prednisolone for the Treatment of an Acute Asthma Exacerbation in the Pediatric Population
Shannan Eades, Jessica Hoover February 02, 2017
To compare efficacy and safety outcomes between children receiving a two-dose regimen of dexamethasone and children receiving a multidose regimen of oral prednisone/prednisolone for the treatment of acute asthma exacerbations not requiring admission to the intensive care unit.
- To determine if Asthma Assessment Scores differ between groups.
- To determine if use of adjunctive medications, length of stay, transfer to the intensive care unit, and 7- and 30-day hospital readmission rate differ between groups.
- To determine if gastrointestinal tolerance after corticosteroid administration differs between groups.
- Patients 4-17 years of age
- Hospitalized for an acute asthma exacerbation
- ICD-9-CM code: 493.92
- ICD-10-CM code: J45.901
- Received therapy with either dexamethasone or prednisone/prednisolone
- Admitted to Children’s Memorial Hermann Hospital
- Admitted between January 1, 2014 to September 30, 2016
- Pregnant
- Required initial management in the intensive care unit
- Received corticosteroid therapy due to a secondary diagnosis (e.g., croup or anaphylactic shock)
- Received therapy with both dexamethasone and prednisone/prednisiolone
- Received therapy with racemic epinephrine
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Clinical characteristics: age, gender, weight, height, asthma severity (intermittent, mild persistent, moderate persistent, severe persistent)
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Admit diagnosis
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Length of hospitalization
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Asthma Assessment Score
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Medication
- Dexamethasone dose (mg), duration of therapy, dosing interval (days and hours)
- Prednisone/prednisolone/methylprednisolone dose (mg), number of doses, duration of therapy, dosing interval (days and hours)
- Total albuterol (mg), ipratropium (mg), magnesium (mg), terbutaline (mg)
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7- and 30-day hospital readmission
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Transfer to the ICU during admission
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Episodes of nausea/vomiting after corticosteroid administration
The main outcome measured will be Asthma Assessment Score.
Additional outcomes measured will be use of adjunctive medications for asthma exacerbation, length of hospitalization, 7- and 30-day hospital readmission, and transfer to an ICU after admission.