A Cochrane review [Abstract] 1 included 2 studies with a total of 303 subjects. The intervention was a single 2 mg per kg dose of prednisolone in the first study, and 20 mg of prednisolone administered once daily for 5 days in the second study. The trials did not find evidence that parent-initiated OCS are associated with a benefit in terms of hospital admissions, unscheduled medical reviews, symptoms scores, bronchodilator use, parent and patient impressions, physician assessment, or days lost from work or school. The data from the first paper suggest that children treated with prednisolone may be more likely to require an unscheduled medical review.
Comment: The quality of evidence is downgraded imprecise results (few patients and wide confidence intervals) and by inconsistency (heterogeneity in interventions and outcomes; disease severity difficult to quantify, difficult to know if medication was started for an appropriate indication).
Primary/Secondary Keywords