From the Research
Comparison of Prednisolone and Dexamethasone for Acute Bronchospasm
- The effectiveness of prednisolone and dexamethasone for acute bronchospasm in reactive airway disease has been compared in several studies 1, 2, 3.
- A randomized control trial found that oral dexamethasone was more effective than oral prednisolone in managing acute exacerbation of asthma, with significant improvements in respiratory rate, use of accessory muscles, and Pediatric Respiratory Assessment Measure (PRAM) score 1.
- Another study found that single-dose dexamethasone was at least as effective as a 5-day course of prednisolone in controlling asthma, while dexamethasone for 2 days was non-inferior to 5 days of prednisolone in children with asthma exacerbation 2.
- A prospective randomized trial found that 2 days of oral dexamethasone was as effective as 5 days of oral prednisone in improving symptoms and preventing relapse in children with acute asthma, with improved compliance and fewer side effects 3.
Mechanism of Action and Dosage
- Corticosteroids, such as dexamethasone and prednisolone, exert a strong suppressive influence on the basic inflammatory response that leads to tissue swelling 4.
- The recommended initial doses for acute airway obstruction are dexamethasone, 1.0 to 1.5 mg/kg, or methylprednisolone, 5 to 7 mg/kg 4.
- A study found that early administration of dexamethasone could reduce duration of mechanical ventilation and overall mortality in patients with established moderate-to-severe acute respiratory distress syndrome (ARDS) 5.
Side Effects and Compliance
- Oral dexamethasone was shown to have less incidence of vomiting/gastritis than prednisolone 1.
- A study found that more children in the prednisolone group were excluded for vomiting, and more parents were noncompliant with the treatment regimen 3.
- Dexamethasone was found to have a similar efficacy to prednisone with improved compliance and fewer side effects in children with acute asthma 3.