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  • Prednisone/Prednisolone – 2 mg/kg (maximum 60 mg)
  • Dexamethasone (oral) – 0.6 mg/kg (maximum 12 mg), for 1 or 2 days)
  • Methylprednisolone (IV) – 2 mg/kg (maximum 60 mg)

Key Result:

CSs have similar efficacy, and short-term adverse events outcomes are not found in otherwise healthy children (Fernandes et al., 2014). Long term adverse events (such as hypertension, adrenal suppression) outcomes are poorly studied. The decision to select one or another for treatment may be based on compliance to treatment and adverse events including (a) vomiting in the ED, (b) vomiting at home, and (c) adrenal suppression in children with frequent asthma exacerbations. No studies were identified that evaluated these as primary outcomes.

For additional information click here for the Oral Dexamethasone vs. Prednisone for a Pediatric Asthma Exacerbation Critically Appraised Topic (CAT), or here for more informtation on the Dose of Glucocorticosteroids for Asthma in the ED/UCC. 


Fernandes, R. M., Oleszczuk, M., Woods, C. R., Rowe, B. H., Cates, C. J., & Hartling, L. (2014). The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: an overview of reviews. Evid Based Child Health, 9(3), 733-747. doi:10.1002/ebch.1980

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.