Aljebab Fahad, Alanazi Mofadhi, Choonara Imti, Conroy Sharon
Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
Gurayat General Hospital, Ministry of Health, Gurayat, Saudi Arabia.
Arch Dis Child. 2018 Jan;103(1):83-88. doi: 10.1136/archdischild-2017-312697. Epub 2017 Jul 22.
Short-course oral corticosteroids are routinely used to treat acute asthma and croup. We evaluated their tolerability and palatability in Saudi Arabian (SA) and UK children.
Prospective observational/interview study (3 months in each country). Palatability was evaluated using a 5-point facial Hedonicscale and tolerability by direct questioning of patient/parents.
In SA, of 122 patients (2-10 years) recruited, 52 received prednisolone base tablets, 37 prednisolone sodium phosphate syrup and 33 received dexamethasone elixir. In the UK, of 133 patients (2-16 years), 38 received prednisolone base tablets (mainly crushed and dispersed), 42 prednisolone sodium phosphate soluble tablets and 53 received dexamethasone sodium phosphate oral solution.In both countries, dexamethasone had the highest palatability scores (SA mean: 1.97; UK mean: 3) and prednisolone base tablets had the lowest (SA mean: 1.12; UK mean: 1.39). Palatability scores improved for all formulations of prednisolone with each subsequent daily dose.In SA, prednisolone base tablets were associated with more nausea (24vs7 patients) and vomiting (5vs0 patients) than sodium phosphate syrup (p=0.008 and p=0.073, respectively). In the UK, vomiting occurred more frequently with prednisolone base (8 patients) than sodium phosphate soluble tablets (2 patients) (p=0.041).In both centres, dexamethasone was associated with less side effects. Vomiting (1vs0 patients), nausea (7vs3 patients) and abdominal pain (10vs8 patients) occurred more with dexamethasone sodium phosphate solution than dexamethasone elixir.
Dexamethasone sodium phosphate solution was the most palatable preparation. Prednisolone base tablets were rated least palatable and were least well tolerated. Palatability scores improved with each dose taken.
短疗程口服糖皮质激素常用于治疗急性哮喘和哮吼。我们评估了其在沙特阿拉伯（SA）和英国儿童中的耐受性和口感。
前瞻性观察/访谈研究（每个国家为期3个月）。使用5分面部享乐量表评估口感，并通过直接询问患者/家长来评估耐受性。
在沙特阿拉伯，招募的122名患者（2至10岁）中，52人服用泼尼松龙片，37人服用泼尼松龙磷酸钠糖浆，33人服用地塞米松酏剂。在英国，133名患者（2至16岁）中，38人服用泼尼松龙片（主要是碾碎后分散服用），42人服用泼尼松龙磷酸钠可溶性片，53人服用地塞米松磷酸钠口服溶液。在两个国家，地塞米松的口感评分最高（沙特阿拉伯平均分为1.97；英国平均分为3），泼尼松龙片最低（沙特阿拉伯平均分为1.12；英国平均分为1.39）。泼尼松龙的所有制剂随着每日后续剂量的增加，口感评分有所改善。在沙特阿拉伯，与磷酸钠糖浆相比，泼尼松龙片导致更多恶心（24例对7例患者）和呕吐（5例对0例患者）（p分别为0.008和0.073）。在英国，泼尼松龙片导致的呕吐比磷酸钠可溶性片更频繁（8例患者对2例患者）（p = 0.041）。在两个中心，地塞米松的副作用较少。与地塞米松酏剂相比，地塞米松磷酸钠溶液导致更多呕吐（1例对0例患者）、恶心（7例对3例患者）和腹痛（10例对8例患者）。
地塞米松磷酸钠溶液是口感最佳的制剂。泼尼松龙片的口感评分最低，耐受性也最差。随着每次服用剂量的增加，口感评分有所改善。
