CONTROLLED TRIAL OF ORAL PREDNISONE IN THE EMERGENCY DEPARTMENT TREATMENT OF CHILDREN WITH ACUTE ASTHMA

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 401-402
Author(s):  
Brett Kettelhut ◽  
Napoleon Lee ◽  
Roger H. Kobayashi
Keyword(s):  
Emergency Department ◽  
Acute Asthma ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Hospitalization Rate ◽  
Emergency Department Setting

Initiation of oral prednisone in an emergency department setting reduced the hospitalization rate in a subset of children.

scholarly journals A Randomised Controlled Trial of High Dose, Inhaled Budesonide Versus Oral Prednisone in Patients Discharged from the Emergency Department following an Acute Asthma Exacerbation

2000 ◽  
Vol 7 (1) ◽  
pp. 61-67 ◽  
Author(s):  
J Mark FitzGerald ◽  
David Shragge ◽  
Jennifer Haddon ◽  
Barbara Jennings ◽  
Joanna Lee M Math ◽  
...  
Keyword(s):  
Emergency Department ◽  
Relapse Rate ◽  
Acute Asthma ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Final Visit ◽  
High Dose ◽  
Forced Expiration ◽  
Double Blind

OBJECTIVE:Prednisone (PRED) is recommended at discharge to reduce the relapse rate following emergency treatment for an asthmatic attack. However, PRED has systemic side effects. Inhaled anti-inflammatory medications, such as budesonide (BUD), are well tolerated. This study was designed to compare the effectiveness of PRED and BUD on relapse rate.DESIGN:A prospective, randomized, double-blind, double dummy, parallel group design.SETTING:Tertiary referral emergency departments.POPULATION STUDIED:One hundred and eighty-five patients with acute asthma who received standard treatment with bronchodilators and systemic glucocorticosteroids in the emergency department, had a forced expiration volume in 1 s (FEV1) greater than 50% predicted and who were deemed well enough to be discharged from the emergency department.INTERVENTION:Patients were randomized to receive either BUD Turbuhaler 600 µg qid or PRED 40 mg in the morning for seven to 10 days. At discharge and final visit, symptoms, medication use, FEV1,peak expiratory flow (PEF) and quality of life (QoL) were assessed. Relapse rate to the emergency department during the follow-up was determined by a yes and/or no questionnaire.MAIN RESULTS:The PRED (n=85) and BUD (n=90) treatment groups were comparable at baseline (emergency department discharge) for age (mean ± SD; 27.6±8.5 years and 29.2±8.7 years) and prebronchodilator FEV1(1.77±0.79 L and 1.75±0.78 L), respectively. BUD was at least as effective as PRED in preventing a relapse to the hospital; relapse rate was 10 (11.8%) during PRED treatment and nine (10.0%) for BUD treatment (95% CI PRED-BUD, -7.5% to 11.0%). Improvements in FEV1, asthma symptoms, PEF and QoL were not significantly different between treatments.CONCLUSIONS:In  patients whose acute asthma has been stabilized in the emergency department, high dose BUD may be an alternate to PRED as a follow-up treatment.

Controlled Trial of Oral Prednisone in the Emergency Department Treatment of Children With Acute Asthma

PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Richard J. Scarfone ◽  
Susan M. Fuchs ◽  
Alan L. Nager ◽  
Steven A. Shane
Keyword(s):  
Emergency Department ◽  
Placebo Group ◽  
Acute Asthma ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Agonist Therapy ◽  
Double Blind ◽  
Oral Corticosteroids ◽  
Emergency Department Patients ◽  
Β2 Agonist

Background. Recent studies have shown that the use of parenteral corticosteroids in the emergency department decreases the hospitalization rate for patients with acute asthma. We studied the efficacy of oral corticosteroids in the emergency department treatment of moderately ill children with acute asthma. Methods. Emergency department patients aged 1 through 17 years whose chief complaint was acute asthma were assigned a pulmonary index, based on clinical evaluation. Those with a moderate exacerbation (pulmonary index = 9 through 13) received either 2 mg/kg of oral prednisone or placebo in a randomized, double-blind fashion. Patients in each group were then treated with an identical regimen of frequent aerosolized albuterol, for up to a maximum of 4 hours. Results. Seventy-five patients were assessed. Overall, 11 (31%) of 36 in the prednisone group required hospitalization compared with 19 (49%) of 39 in the placebo group (P = .10). Among the sickest patients (initial pulmonary index > 10), 7 (32%) of 22 prednisone-treated patients required hospitalization compared with 13 (72%) of 18 placebo-treated patients (P < .05). Among patients who had a suboptimal response to initial β2-agonist therapy and who therefore would have been hospitalized had treatment been restricted to 2 hours, 9 (45%) of 20 in the prednisone group ultimately required hospitalization when duration of care was extended 2 additional hours compared with 15 (83%) of 18 in the placebo group (P < .05). In addition, prednisone-treated patients had a significantly greater improvement in median pulmonary index (5.0 vs 3.0, P < .001). Conclusions. These data demonstrate that oral prednisone, within 4 hours of its administration, reduced the need for hospitalization among a subset of children treated in the emergency department for acute asthma.

A controlled trial of methylprednisolone in the early emergency department treatment of acute asthma in children

1994 ◽  
Vol 10 (6) ◽  
pp. 335-338 ◽  
Author(s):  
DAVID H. WOLFSON ◽  
MICHELE M. NYPAVER ◽  
MARK BLASER ◽  
AUDREY HOGAN ◽  
RICHARD EVANS ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Asthma ◽  
Controlled Trial ◽  
Asthma In Children

Comparison of Intramuscular Triamcinolone and Oral Prednisone in the Outpatient Treatment of Acute Asthma: A Randomized Controlled Trial

1998 ◽  
Vol 31 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Hugh Schuckman ◽  
Dennis P DeJulius ◽  
Michelle Blanda ◽  
Lowell W Gerson ◽  
Angela J DeJulius ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Outpatient Treatment ◽  
Acute Asthma ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Randomized Controlled
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