Parent-initiated prednisolone cuts child asthma symptoms

Prednisolone treatment initiated by parents can reduce acute asthma symptoms in schoolchildren, research suggests.

Research has shown a reduction in acute asthma symptoms in children treated with prednisolone (Photograph: SPL)
Research has shown a reduction in acute asthma symptoms in children treated with prednisolone (Photograph: SPL)

Researchers at Geelong Hospital in Australia examined the effect of parent-initiated oral prednisolone treatment on acute asthma in 230 children aged 5-12 years with a history of recurrent asthma.

Previous studies failed to find a benefit associated with parent-initiated oral corticosteroid treatment. But with asthma a leading cause of hospital admission, the authors identified a clear need to reduce burden on health resources.

In a three-year study the researchers assessed children's daytime and night-time symptoms using a scoring diary.

In total, 308 episodes requiring intervention occurred and the children who experienced these were treated with either a short course of oral prednisolone 1mg/kg daily or a placebo.

Children given prednisolone showed a 15% reduction in daytime symptom score compared with those treated with placebo.

There was also a 16% reduction in night-time symptom score for children given prednisolone, as well as reduced risk of healthcare resources use and reduced school absenteeism.

But the researchers believe these modest benefits should be balanced against the potential side effects of repeated courses, which include effects on behaviour, adrenal function and reduced adult height in children with asthma.

The authors concluded that parent-initiated oral prednisolone treatment may be suitable for more severe asthma episodes, but this must be balanced against the potentially detrimental side effects of repeated courses.

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