Chest
Clinical InvestigationsSTEROIDSAdverse Behavioral Effects of Treatment for Acute Exacerbation of Asthma in Children: A Comparison of Two Doses of Oral Steroids
Section snippets
Materials and Methods
The Institutional Review Committee of Bridgeport Hospital approved the study. Patients presenting at the hospital or an outpatient asthma center with persistent asthma were identified. Informed consent was obtained. Patients aged 2 to 18 years were eligible for inclusion if at baseline they had mild persistent asthma based on National Institutes of Health guidelines (cough, shortness of breath, or wheeze more than twice a week but less than once a day and similar nighttime symptoms more than
Results
Of 92 families asked to participate, 88 were enrolled. The age, sex, and ethnic distribution in the two groups were comparable. Patients in both groups received three doses of albuterol, 2.5 mg, in a 1-h period. None of the patients needed to be admitted to the hospital. Oral prednisone or prednisolone was prescribed at the discretion of the physician, plus albuterol MDI, 2 puffs q6h for 5 days. As the maximum dose was 60 mg, one child in group 2 did not receive the 2 mg/kg/d dose. All the
Discussion
While the two dose regimens did not produce different benefits in terms of asthma symptoms, behavioral side effects, particularly aggressive behavior and anxiety, were twice as common in patients receiving the 2 mg/kg daily dose. Parents reported that these behavioral symptoms resolved after the discontinuation of oral steroid therapy.
We considered whether reporting bias by the parents could account for the observed difference in behavior. The parents did not know the study outcome variables
ACKNOWLEDGMENT
We would like to acknowledge Yaw Adgepong, MD, for his kind help in doing the statistical analysis in this study.
References (14)
- et al.
Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators
J Pediatr
(1987) - et al.
Psychosis in a child inhaling budesonide [letter]
Lancet
(1983) - et al.
How does home management of asthma exacerbations by parents of inner-city children differ from NHLBI guideline recommendations?
Pediatrics
(1999) - et al.
Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma
Pediatrics
(1993) - et al.
Short courses of steroids in home treatment of children with acute asthma
BMJ
(1986) - et al.
Independent parental administration of prednisone in acute asthma: a double-blind, placebo-controlled, crossover study
Pediatrics
(1995)