The Efficacy of Oral Betamethasone versus Oral Prednisone in the Management of Acute Asthma

Arshad  Iqbal; Tanzeelah  Shamshad; Raghib  Iqbal; Fiza  Liaquat

doi:10.54112/bcsrj.v6i5.1738

Authors

Arshad Iqbal Pediatric Medicine unit 2 Sheikh Zayed Hospital Rahim Yar Khan, Pakistan
Tanzeelah Shamshad Tehsil Headquarters Hospital Mankera Bhakkar, Pakistan
Raghib Iqbal Pediatric Medicine unit 2 Sheikh Zayed Hospital Rahim Yar Khan, Pakistan
Fiza Liaquat City Hospital Rahim Yar Khan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.1738

Keywords:

Asthma, Pediatrics, Betamethasone, Prednisone, Corticosteroids

Abstract

Acute asthma in children are a major cause of emergency department visits and hospital admissions. Objective: To compare the efficacy and safety of oral betamethasone versus oral prednisone in the management of acute asthma exacerbations in children aged 2 to 12 years. Methods: This randomized controlled trial was conducted at the Department of Pediatrics, Sheikh Zayed Hospital, Rahim Yar Khan from Oct 2024 to March 2025. A total of 166 children presenting to the emergency department with acute asthma exacerbations were enrolled using non-probability consecutive sampling. Participants were randomly assigned to receive either oral prednisone (n=83) or oral betamethasone (n=83). Results: The mean length of hospital stay was 47.6 ± 12.3 hours in the prednisone group and 49.9 ± 13.8 hours in the betamethasone group (p = 0.18). Persistence of symptoms occurred in 16.9% of the prednisone group and 20.5% of the betamethasone group (p = 0.54). Rates of ED revisits (12.0% vs. 14.5%), hospital readmissions (6.0% vs. 8.4%), and steroid-related side effects (9.6% vs. 7.2%) were similar between groups, with no statistically significant differences. Conclusion: It is concluded that oral betamethasone is as effective and safe as oral prednisone in treating acute asthma exacerbations in children. Given its pharmacokinetic profile, betamethasone may offer practical advantages in clinical settings, warranting further exploration in future studies.

Downloads

Download data is not yet available.

References

Tesse R, Borrelli G, Mongelli G, Mastrorilli V, Cardinale F. Treating Pediatric Asthma according guidelines. Front Pediatr. 2018;6:234.

Razzaq S, Nafees AA, Rabbani U, Irfan M, Naeem S, Khan MA, et al. Epidemiology of asthma and associated factors in an urban Pakistani population: adult asthma study-Karachi. BMC Pulm Med. 2018;18(1):184.

Amir Khan M, Ahmar Khan M, Walley JD, Khan N, Imtiaz Sheikh F, Ali S, et al. Feasibility of delivering integrated COPD-asthma care at primary and secondary level public healthcare facilities in Pakistan: a process evaluation. BJGP Open. 2019;3(1):bjgpopen18X101632.

Sheldon G, Heaton PA, Palmer S, Paul SP. Nursing management of paediatric asthma in emergency departments. Emerg Nurse. 2018;26(4):32–42.

Iqbal N, Asif S, Omer R, Hussain KK. Comparison of the Frequency of Relapse After Treatement of Acute Exacerbation of Asthma with Oral Dexamethsone Versus Oral Prednisolone in Children. Esculapio Journal of SIMS. 2021;17(3):227–30.

Gileles-Hillel A, Guttman S, Breuer O, Reiter J, Leshem R, Shoseyov D, et al. Betamethasone versus dexamethasone for inpatient preschool wheezing-A case- control study. Pediatr Pulmonol. 2021;56(5):875–82.

Dharmage SC, Perret JL, Custovic A. Epidemiology of asthma in children and adults. Front Pediatr. 2019;7:246.

Indinnimeo L, The Italian Panel for the management of acute asthma attack in children Roberto Bernardini, Chiappini E, Miraglia del Giudice M. Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics. Ital J Pediatr. 2018;44(1).

Thaweerujirot C, Daengsuwan T. Comparison between pediatric respiratory assessment measure (PRAM) score and Wood’s asthma score to assess acute asthma exacerbation. Asian Pac J Allergy Immunol. 2019;37(3):123–9.

Kirkland SW, Cross E, Campbell S, Villa-Roel C, Rowe BH. Intramuscular versus oral corticosteroids to reduce relapses following discharge from the emergency department for acute asthma. Cochrane Database Syst Rev. 2018 Jun 2;6(6):CD012629. doi: 10.1002/14651858.CD012629.pub2. PMID: 29859017; PMCID: PMC6513614.

Elhennawy MG, Akl Y, Abbassi M, Sabry NA. The effectiveness and pharmacoeconomic study of using different corticosteroids in the treatment of hypersensitivity pneumonitis. BMC Pulm Med. 2024 Feb 15;24(1):87. doi: 10.1186/s12890-024-02896-z. PMID: 38360614; PMCID: PMC10870560.

Flaherty KR, Brown KK, Wells AU, et al. Design of the PF-ILD trial: a double-blind, randomised, placebo-controlled phase III trial of nintedanib in patients with progressive fibrosing interstitial lung disease. BMJ open Respiratory Res. 2017;4(1):e000212. doi: 10.1136/bmjresp-2017-000212.

Alfaro TM, Afonso M, Torrisi SE. Highlights from the 2018 European Respiratory Society Congress presentations on interstitial lung diseases. J Thorac Disease. 2018;10(Suppl 25):3024. doi: 10.21037/jtd.2018.08.101

Barnes H, Troy L, Lee CT, et al. Hypersensitivity pneumonitis: current concepts in pathogenesis, diagnosis, and treatment. Allergy. 2022;77(2):442–53. doi: 10.1111/all.15017

Lee JS, Lee EY, Ha Y-J, et al. Serum KL-6 levels reflect the severity of interstitial lung disease associated with connective tissue disease. Arthritis Res Therapy. 2019;21(1):1–8. doi: 10.1186/s13075-019-1835-9