For children hospitalized with asthma, experts recommend oral prednisone/prednisolone at 1 to 2 mg/kg/day (max, 60 mg/day), in 2 divided doses, for 3 to 5 days. For children with asthma who present to the emergency department (ED), 1 to 2 daily doses of oral dexamethasone 0.6 mg/kg have been shown to be equivalent, with better tolerance and compliance.
Inhaled corticosteroids are indicated for long-term control of asthma but are not efficacious in acute exacerbations.
Systemic corticosteroids are indicated to improve morbidity and decrease hospitalizations for croup. Oral dexamethasone therapy is preferred, at doses ranging from 0.15 mg/kg to 0.6 mg/kg (these doses have been shown to have equal efficacy).
Most Important References
Cross KP, Paul RI, Goldman RD. Single-dose dexamethasone for mild-to-moderate asthma exacerbations: effective, easy, and acceptable. Can Fam Physician. 2011;57(10):1134-1136. (Review)
Evaniew N, Belley-Cote EP, Fallah N, et al. Methylprednisolone for the treatment of patients with acute spinal cord injuries: a systematic review and meta-analysis. J Neurotrauma. 2016;33(5):468-481. (Systematic review, meta-analysis; 4 randomized controlled trials and 17 observational studies) DOI: http://dx.doi.org/10.1089/neu.2015.4192