Single-dose Dexamethasone versus multi-dose Prednisolone in the prevention of exacerbation and relapse in Asthmatic children; a Randomized Controlled Trial.

Introduction: Asthma is a common chronic inflammatory disease of the airways characterized by reversible airflow obstruction, and bronchospasm. The first line of treatment in the management of acute asthma is inhaled beta 2 agonists (salbutamol). This study is designed to determine the effectiveness of intravenous dexamethasone compared to oral prednisolone in asthmatic children in preventing exacerbation and relapse. It may be more helpful in improving the quality of life of asthmatic children being a better convenient treatment modality. Aim: To compare the frequency of relapse of asthma with dexamethasone and prednisolone in the treatment of asthma exacerbations in children. Subject and Methods: This is a randomized controlled study that was conducted at the ICU of the Paediatric Department, Holy Family Hospital from 16th March 2016 to 15th September 2016. 468 patients with asthma exacerbation were selected in this study. Patients were randomly allocated into two groups. A total of 234 patients in group A were treated with single IV dose Dexamethasone and 234 in group B were treated with oral prednisolone. Baseline characteristics of children were recorded in the structured proforma along with signs and symptoms assessed through history, physical examination and PRAM (Paediatric Respiratory Assessment Measurement) Scoring. After treatment and assessment, the patients were discharged on day 5 and they were called back by the end of 2 weeks for the final follow up visit. In case of any relapse, they were clearly instructed to immediately return to the hospital which was recorded. Results: The average age of the children 3.31±0.97 years. There were 173(37%) females and 295(63%) males. The rate of relapse was significantly low in group A as compared to group B (9.8% vs. 17.9% p=0.011). Conclusion: it is concluded that dexamethasone is an effective alternative to prednisone in the treatment of moderate acute asthma exacerbations in children, with the added benefits of improved compliance and cost. [ABSTRACT FROM AUTHOR]