Corticosteroid Therapy for Children in Pediatric Emergency Department

Abstract

Corticosteroids are effective and established treatments in various inflammatory and autoimmune disorders. These drugs have a potent anti-inflammatory effect and can be administered systemically or by inhalation, which can be combined with other treatments in the pediatric emergency department. Despite their beneficial effects, however, corticosteroid therapy is associated with many well-known side effects. Many of these side effects can be minimized through the lowest effective dose and duration required for the management of underlying conditions. The objectives of this article are to review a practical guide to corticosteroid therapy in the emergency department.

The impact of single dose intravenous dexamethasone as an adjunctive therapy for primary treatment on concentrations of inflammatory biomarkers in children with Kawasaki disease

“…Intravenous methylprednisolone combined with IVIG as the pri-mary treatment is associated with a shorter fever duration and length of hospital stay, and faster reduction in concentrations of inflammatory markers and conventional clinical markers, in comparison with IVIG alone [12][13][14] . Dexamethasone is 25-30 times more potent than hydrocortisone in antiinflammatory effect, and has a 36-72 hours duration of action 15) . This strength of dexamethasone makes its indications for acute and serious diseases, such as croup, acute exacerbations of asthma, and anaphylaxis 15) .…”

“…Dexamethasone is 25-30 times more potent than hydrocortisone in antiinflammatory effect, and has a 36-72 hours duration of action 15) . This strength of dexamethasone makes its indications for acute and serious diseases, such as croup, acute exacerbations of asthma, and anaphylaxis 15) . Dexamethasone in KD may attenuate the cytokine reactions in vivo 13) , and inhibit the activation of monocytes, macrophages, coronary arterial endothelial cells, and T cells in vitro 16) .…”