What is the recommended dose, frequency, and duration of prednisone for a 9-year-old with urticaria?

From the Guidelines

Prednisone is recommended at a dose of 1-2 mg/kg/day, with a maximum dose of 50 mg/day, for a short course of 3-5 days for a 9-year-old with acute urticaria.

Dosing and Frequency

• The dose of prednisone for a 9-year-old with urticaria can be calculated based on weight, with a typical dose range of 1-2 mg/kg/day [@\1@, @\2@].
• A maximum dose of 50 mg/day is often used in adults, but for a 9-year-old, the dose would be lower, approximately 20-30 mg/day [@\2@].
• The frequency of administration is typically once daily, given the long half-life of prednisone.

Duration of Treatment

• The duration of treatment with prednisone for acute urticaria is typically short, ranging from 3-5 days [@\2@].
• Prolonged treatment may be necessary for certain conditions, such as delayed pressure urticaria or urticarial vasculitis, but this would require close monitoring and specialist supervision [@\1@, @\2@].

From the Research

Recommended Dose, Frequency, and Duration of Prednisone for Urticaria

• The recommended dose, frequency, and duration of prednisone for a 9-year-old with urticaria are not explicitly stated in the provided studies 1, 2, 3, 4, 5.
• However, study 2 mentions that a course of oral corticosteroids (starting with prednisone 25 mg/day for 3 days) was prescribed to adult patients with chronic urticaria who reported little or partial response to antihistamine treatment.
• Study 3 mentions that patients with acute urticaria were given oral prednisolone as discharge medication for 5 days, in addition to IV chlorpheniramine and IV dexamethasone.
• Study 4 mentions that patients with acquired cold urticaria were treated with prednisone in an oral dose of 20-25 mg for 1 to 5 days.
• Study 5 provides a systematic review and meta-analysis of randomized clinical trials, but does not specify a recommended dose, frequency, and duration of prednisone for urticaria.

Considerations for Treatment

• The use of systemic corticosteroids, such as prednisone, for urticaria is commonly used, but their benefits and harms are unclear 5.
• The addition of corticosteroids to antihistamines may improve urticaria activity, but also increases the risk of adverse events 5.
• The effectiveness of corticosteroids in antihistamine-resistant chronic urticaria is widely accepted, although large studies on their use in this disease are lacking 2.

Limitations of Current Evidence

• There is a lack of well-designed clinical trials evaluating the use of corticosteroids in acute urticaria 1, 3.
• Most studies focus on chronic urticaria rather than acute urticaria 1, 2, 5.
• The state-of-the-art management of acute urticaria remains unclear due to the limited evidence available 1.