In this edition of Vital Signs, treating children with asthma. Doctors usually choose between two steroids to treat acute attacks that require a hospital stay. But a new study in the "Journal of Pediatrics" found one of the steroids – dexamethasone -- had additional benefits for hospitals, patients and their parents.
Dr. Vineeta Mittal, a Pediatric Hospitalist with Children’s Health and an Associate Professor of Pediatrics with UT Southwestern Medical Center, co-authored the study.
Highlights from Dr. Mittal’s interview:
Differences between prednisone and dexamethasone: Prednisone has a shorter half life. That means you have to give it more often, more frequently. Dexamethasone is a longer half life of 36 to 72 hours. It is more potent, so one to two doses are sufficient and are equal to five days of prednisone.
Reasons for testing the two steroids: Giving prednisone four to five days, often kids would vomit in the emergency room. Often we’d have to redose. So that prompted to see if there was any other way of giving another drug that could be used less frequently and has lesser side effects. The results found dexamethasone was as effective. Side effects were less. And it was cheaper as well. So that prompted the emergency room study. Then we did it in the inpatient and it had the same results as in the emergency room.
Results of the switch: It’s easier for parents. Maybe less missed school days and school times for patients and families. Main thing is two days versus five days. For my child, if I have an option to give something for two days that is as effective and has lesser side effects and cheaper for me, why would I use something for five days?
Why is Children’s Health just finding out about this? I think we have better database available. We didn’t have databases that would look at 42 children’s hospital’s practice. Now through Children’s Hospital Association, we have database of 42 children’s hospitals, which still only represents 20-percent of children’s database nationally. There are a lot of children’s hospitals within adult hospital, community hospitals – we don’t have those. We need more data. And I think this all fits in the technology health care boom and everything coming together, so we have the luxury of the database so we can do those studies now.
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