Abstract
The treatment of an acute asthma attack usually includes bronchodilators and often steroids. We studied 70 children who were randomly assigned to receive either single dose steroids (oral prednisone: 20–40 mg) or placebo on a double blind basis. The time course of the observation was 72 h. We demonstrate that a single dose of steroids, given orally in paediatric community clinics during an acute mild to moderate asthma attack, significantly improves the patient's course; deterioration was prevented, symptoms were relieved faster, and hospitalization was not required. We encourage paediatricians in the ambulatory clinics to follow this treatment modality and to give, in addition to other conventional therapy, a single oral dose of steroids early in the asthma attack, in order to relieve and shorten the child's distress.
Similar content being viewed by others
References
Barnes NC (1992) Effect of corticosteroids in acute severe asthma. Thorax 47: 582–583
Barnes PJ, Pedersen S (1993) Efficacy and safety of inhaled corticosteroids in asthma. Ann Rev Respir Dis 148 (Suppl) 1–26
Becker AB, Nelson NA, Simons FER (1984) The pulmonary index. Assessment of a clinical score for asthma. Am J Dis Child 138: 574–576
Bierman CW, Pierson WE (1974) The pharmacologic management of status asthmaticus in children. Pediatrics 54: 245–248
Chapman KR, Verbeek PR, White JG, Rebuck AS (1991) Effect of a short course of prednisone in the prevention of early relapse after the ER treatment of acute asthma. N Engl J Med 324: 788–794
Cockcroft DW (1988) Airway hyperresponsiveness and late asthmatic responses. Chest 94: 178–180
Editorial (1992) Lancet 340: 1384–1385
Engel T, Heinig JH (1991) Glucocorticoid therapy in acute severe asthma — a critical review. Eur Respir J 4: 881–889
Fanta CH, Rossing TH, McFadden ER (1983) Glucocorticoids in acute asthma. Am J Med 74: 845–851
Fiel SB, Swartz MA, Glanz K, Francis ME (1983) Efficacy of short-term corticosteroid therapy in outpatient treatment of acute bronchial asthma. Am J Med 75: 259–262
Harris JB, Weinberger MM, Nassif E, Smith G, Milavetz G, Stillerman A (1987) Larly intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr 110: 627–633
Kattan M, Gurwitz D, Levison H (1980) Corticosteroids in status asthmaticus. J Pediatr 96: 596–599
Leffert F (1980) The management of acute severe asthma. J Pediatr 96: 1–12
Littenberg B, Gluck EH (1986) A controlled trial of methylprednisolone in the emergency treatment of acute asthma. N Engl J Med 314: 150–152
McFadden ER (1988) Corticosteroids and cromolyn sodium as modulators of airway inflammation. Chest 94: 181–184
McFadden ER, Kiser R, deGroot WJ, Holmes B, Kiker R, Viser G (1976) A controlled study of the effects of single doses of hydrocortisone on the resolution of acute attacks of asthma. Am J Med 60: 52–59
Pierson WE, Bierman CW, Kelley VC (1974) A double-blind trial of corticosteroid therapy in status asthmaticus. Pediatrics 54: 282–288
Schneider SM, Pipher A, Britton HL, Borok Z, Harcup Ch (1988) High-dose methylprednisolone as initial therapy in patients with acute bronchospasm. J Asthma 25: 189–193
Shapiro GG, Furukawa CT, Pierson WE, Gardinier R, Bierman CW (1983) Double-blind evaluation of Methylprednisolone versus placebo for acute asthma episodes. Pediatrics 71: 510–514
Stein LM, Cole RP (1990) Early administration of corticosteroids in ER treatment of acute asthma. Ann Intern Med 112: 822–827
Storr J, Barry W, Barrell E, Lenney W, Hatcher G (1987) Effect of a single oral dose of prednisolone in acute childhood asthma. Lancet 1: 879–881
Tal A, Levy N, Bearman JE (1990) Methylprednisolone therapy for acute asthma in infants and toddlers: a controlled clinical trial Pediatrics 86: 350–356
Taylor IK, Shaw RJ (1993) The mechanism of action of corticosteroids in asthma. Respir Med 87: 261–277
Weinberger M (1989) Antiasthmatic therapy in children. Pediatr Clin N Am 36: 1251–1284
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Horowitz, L., Zafrir, O., Berger, I. et al. Acute asthma. Single dose oral steroids in paediatric community clinics. Eur J Pediatr 153, 526–530 (1994). https://doi.org/10.1007/BF01957010
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01957010