Doses of systemic corticosteroids in hospitalised children with acute asthma: A systematic review

Abstract

To present the doses of systemic corticosteroids reported by clinical trials in hospitalised children with acute asthma and to assess the possible relationship between doses of corticosteroids and clinical responses. An electronic search of MEDLINE databases (January 1949-February 2005) and Cochrane Controlled Clinical Trials Register (February 2005) was undertaken using a combination of indexing terms related to systemic corticosteroids and acute asthma. Studies were selected if they met the following criteria: (i) randomized controlled trial; (ii) children aged 1-18 years and admitted to hospital for acute asthma; and (iii) treatment group consisting of systemic corticosteroids. Nine trials were included for this review. There was considerable variation between the reported doses of systemic corticosteroids. Only two trials assessed clinical responses to different doses of systemic corticosteroids. Both trials failed to show any therapeutic advantage of higher doses over lower doses. The results of the two trials were not suitable for pooling. Current data are not sufficient for establishing dose-response relationship of systemic corticosteroids in hospitalised children with acute asthma. Larger randomized trials are needed.