Efficacy of Single Dose Oral Dexamethasone Over Multidose Prednisolone for Treatment of Acute Asthma Exacerbation in Children

Haisam Khan; Sohail Ashraf; Hafiz Aaqib Mehboob; Saad Aziz

doi:10.70749/ijbr.v3i4.1998

Authors

Haisam Khan Department of Pediatrics, POF Hospital Wah Cantt, Pakistan
Sohail Ashraf Department of Pediatrics, POF Hospital Wah Cantt, Pakistan
Hafiz Aaqib Mehboob Department of Pediatrics, POF Hospital Wah Cantt, Pakistan
Saad Aziz Department of Pediatrics, POF Hospital Wah Cantt, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i4.1998

Keywords:

Pediatric asthma, Dexamethasone, Prednisolone, PRAM score, Corticosteroids, Treatment efficacy

Abstract

Background: Pediatric acute asthma exacerbations are frequent causes of emergency presentations and common reasons for urgent system corticosteroid treatment. While prednisolone has been the accepted first-line treatment for some time now, single-dose dexamethasone has gained increasing recognition as potentially providing improved compliance and side-effect profiles. However, comparative efficacy at the local levels is under-investigated. Objective: To compare the treatment efficacy of single-dose oral dexamethasone and a three-day course of oral prednisolone in pediatric patients presenting with acute asthma exacerbation. Study Design: Randomized controlled trial. Duration and Place of Study: Conducted from July to December 2024 at the Department of Pediatrics, POF Hospital Wah Cantt. Methodology: A total of 68 children aged 4–12 years, diagnosed with asthma and presenting with PRAM scores ≥6, were enrolled through non-probability consecutive sampling and randomized into two equal groups. Group A received single-dose dexamethasone (0.6 mg/kg, max 12 mg), followed by placebo for two days; Group B received prednisolone (1 mg/kg/day, max 40 mg) for three days. Treatment efficacy was defined as no need for additional systemic steroids at follow-up and >50% improvement in PRAM score. Results: Both groups showed clinical improvement, with Group A exhibiting greater reduction in mean PRAM scores (3.24±0.89 vs. 4.12±0.84). Treatment efficacy was higher in the dexamethasone group (91.2% vs. 79.4%), though the difference was not statistically significant (p=0.305). No significant associations were found with age or gender. Conclusion: Single-dose oral dexamethasone is an effective alternative to multidose prednisolone for acute asthma exacerbations in children, offering comparable outcomes with potentially improved compliance.

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