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Systematic review and meta-analysis
Dexamethasone may be a viable alternative to prednisone/prednisolone for the treatment of acute asthma exacerbation in the paediatric emergency department
  1. Annie L Andrews1,
  2. Annie N Simpson2
  1. 1Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to: Dr Annie L Andrews, Department of Pediatrics, Medical University of South Carolina, 135 Rutledge Ave MSC 561 Charleston, SC 29425, USA; andrewsan{at}musc.edu

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Context

Standard of care for emergency department (ED) treatment of children with acute asthma exacerbation includes systemic steroids.1 Traditionally, the systemic steroid course of choice has been a 5-day burst of oral prednisone or prednisolone. Recent studies have begun to show that a shorter course of dexamethasone may have comparable efficacy.2–4 Dexamethasone is an attractive alternative to prednisone and prednisolone because of its longer duration of metabolic effect and subsequent shorter treatment duration. Others have touted the palatability of dexamethasone over that of prednisone and prednisolone, as well as potentially improved clinical outcomes and cost savings due to superior compliance with the shorter treatment course dexamethasone requires.5

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