Double-blind trial of steroid tapering in acute asthma

Achieving control of asthma in preschoolers

“…52 Tapering is not necessary for short (even 10-day) courses of therapy. 92 Dexamethasone syrup has a longer physiologic half-life than prednisone, and a 2-day course of this medication, at a dose of 0.15 mg/kg, 93 may therefore be just as effective as 5 days of treatment with prednisone. In patients with mild to moderate exacerbations, a single dose of dexamethasone of 0.6 mg/kg may be similarly effective.…”

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

“…Oral dexamethasone for 2 days can also be used but there are concerns about metabolic side-effects if it is continued beyond 2 days. 375 Evidence from studies in which all patients were taking maintenance ICS after discharge suggests that there is no benefit in tapering the dose of OCS, either in the short term 376 or over several weeks 377 (Evidence B).…”

Management of acute asthma in adults in the emergency department: nonventilatory management

“…Gradual tapering of the dose is unnecessary if the duration of oral corticosteroid use is less than one to two weeks. 164,166 In a randomized controlled trial, the addition of high-dose inhaled corticosteroids to a course of oral corticosteroids at discharge was associated with a lower risk of relapse of the asthma exacerbation at 21 days than the use of oral corticosteroids alone. 167 In a recent prospective study of asthma care in the emergency department, the risk of relapse at 28 days was inversely correlated with new prescriptions for inhaled corticosteroids at the time of discharge from the emergency department.…”