Prednisone Dosing for Severe Poison Ivy in 8-Year-Old Female
For an 8-year-old female weighing 65 pounds (29.5 kg) with severe poison ivy, the recommended prednisone dose is 1-2 mg/kg/day (29-59 mg/day) for 5 days, with no taper needed for this short course.
Dosing Calculation
Weight-based dosing approach:
- For severe poison ivy dermatitis, prednisone should be dosed at 1-2 mg/kg/day
- For a 65-pound (29.5 kg) child:
- Minimum dose: 29.5 kg × 1 mg/kg = 29.5 mg daily
- Maximum dose: 29.5 kg × 2 mg/kg = 59 mg daily
- Practical dosing: 30 mg daily for 5 days (no taper needed)
Alternative calculation method:
- Using the pediatric equation from research: [2 × W + 8] for 60 mg/m² equivalent 1
- [2 × 29.5 + 8] = 67 mg daily
- This is slightly higher than the weight-based calculation
Administration Guidelines
- Administer as a single morning dose before 9 AM to minimize adrenal suppression 2
- Give with food or milk to reduce gastric irritation 2
- For liquid formulation, ensure accurate measurement using an oral syringe
- A 5-day course without taper is sufficient for severe poison ivy 3
Duration of Treatment
- Short course (5 days) is generally sufficient for severe poison ivy 3
- No taper is needed for short-term therapy of less than 14 days
- Research shows no significant difference in outcomes between short course (5 days) and longer tapered courses (15 days) for severe poison ivy 3
Monitoring and Side Effects
- Common short-term side effects include:
- Behavioral changes (hyperactivity, emotional lability)
- Increased appetite
- Sleep disturbances
- If behavioral issues occur, consider administering the medication in the afternoon after school 4
- For this short course, serious side effects are unlikely
Important Considerations
- For children who are significantly overweight, dosing should be based on ideal body weight rather than actual weight 4
- Maximum dose of prednisone should generally not exceed 80 mg daily in children 4
- Avoid abrupt discontinuation if the course extends beyond 14 days
- If symptoms persist beyond 5 days of treatment, reassess for secondary infection or alternative diagnosis
Special Situations
- If the rash is particularly severe or widespread, consider dividing the daily dose into two equal doses
- If the child has diabetes, monitor blood glucose more frequently during treatment
- If the child is on other medications, check for potential drug interactions
This short-course prednisone treatment should effectively manage severe poison ivy dermatitis while minimizing the risk of steroid-related adverse effects.