Use of dexamethasone and prednisone in acute asthma exacerbations in pediatric patients.
QUESTION
Children frequently present to my rural emergency department with asthma exacerbations. Should I prescribe systemic corticosteroids? If so, which systemic corticosteroid should I prescribe?


ANSWER
A short course of steroids is indicated in the treatment of asthma exacerbations. Both prednisone (1 to 2 mg/kg daily for 5 days) and dexamethasone (0.3 to 0.6 mg/kg daily for 1 to 5 days) are effective in reducing hospital admissions and unscheduled return to care, with minimal side effects.