From the Department of Pediatrics, Division of Emergency Medicine and Emergency Department, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
Pediatr Emerg Care. 2021 Jul 1;37(7):343-347. doi: 10.1097/PEC.0000000000002036.
Dexamethasone has emerged as a viable alternative to prednisone in the treatment of pediatric acute asthma exacerbations, with the potential for improved compliance secondary to decreased frequency of dosing, improved taste, and decreased cost. The objective of this study is to identify whether providers are prescribing dexamethasone for pediatric acute asthma exacerbations. Secondary objectives are to describe variation in practice between different specialties and to identify the commonly used dosing and frequency for dexamethasone.
We conducted a cross-sectional, descriptive study with an anonymous, web-based survey (surveymonkey.com). The survey population included all fellowship program directors listed on FRIEDA Online for pediatric emergency medicine, pediatric pulmonology, and allergy and immunology, and emergency medicine residency directors through the Council of Emergency Medicine Residency Directors listserv. Program directors were contacted via e-mail up to 5 times for 3 months.
Overall, 300 respondents (70% of the program directors) completed the survey. Response rates by specialty varied from 60% to 94%. One third of providers are using dexamethasone, whereas just more than half of providers (51%) are prescribing a 5-day prednisone course. The preferred maximum dose for dexamethasone is 10 mg (45%), with 82% using a dose of 0.6 mg/kg.Pediatric emergency medicine fellowship directors demonstrated a preference for dexamethasone (59%). Prednisone is favored by emergency medicine (56%), pediatric pulmonology (89%), and allergy and immunology (93%) program directors.
Although most pediatric emergency medicine academic physicians have transitioned to using dexamethasone to treat acute pediatric asthma exacerbations, other specialties continue to favor prednisone.
地塞米松已成为治疗小儿急性哮喘发作的可行替代泼尼松药物，由于减少给药频率、改善口感和降低成本，其潜在依从性提高。本研究的目的是确定临床医生是否开具地塞米松治疗小儿急性哮喘发作。次要目标是描述不同专业之间的实践差异，并确定地塞米松的常用剂量和频率。
我们进行了一项横断面、描述性研究，采用匿名的网络调查（surveymonkey.com）。调查对象包括在 FRIEDA Online 上列出的所有儿科学急诊医学、儿科学肺病学和过敏与免疫学的研究员项目主任，以及通过急诊医学住院医师主任理事会名录列出的急诊医学住院医师主任。通过电子邮件联系主任，在 3 个月内最多联系 5 次。
共有 300 名（研究员项目主任的 70%）受访者完成了调查。各专业的回复率从 60%到 94%不等。三分之一的临床医生使用地塞米松，而只有一半以上的医生（51%）开 5 天泼尼松疗程。地塞米松的首选最大剂量为 10 mg（45%），82%的人使用 0.6 mg/kg 的剂量。儿科学急诊医学研究员项目主任对地塞米松有偏好（59%）。泼尼松更受急诊医学（56%）、儿科学肺病学（89%）和过敏与免疫学（93%）研究员项目主任的青睐。
尽管大多数儿科学急诊医学学术医生已过渡到使用地塞米松治疗小儿急性哮喘发作，但其他专业仍青睐泼尼松。
