A PALATABILITY STUDY OF A FLAVORED DEXAMETHASONE PREPARATION VERSUS PREDNISOLONE LIQUID IN CHILDREN WITH ASTHMA EXACERBATION IN A PEDIATRIC EMERGENCY DEPARTMENT
Main Article Content
Keywords
Corticosteroids, taste, asthma, children
Abstract
Background
Palatability is an important factor in medication compliance for children where the acceptability of a liquid medication and its ease of administration will be greatly affected by its taste.
Objectives
The objective of this study was to determine which, if any of two steroid preparations, oral dexamethasone or oral prednisolone, was more palatable to children requiring steroid treatment for asthma.
Methods
A single-blind taste test of 2 different steroid suspensions, liquid prednisolone (1mg/ml) versus liquid dexamethasone (1mg/ml), was conducted in children aged 5-12 years, presenting to the pediatric emergency department with an exacerbation of asthma requiring steroid treatment. Children received 2.5mls of either prednisolone or dexamethasone and were asked to score their impression of taste on a 10 cm visual analog scale. After cleansing of the palate they were given the other steroid and scored its taste.
Results
Thirty-nine children (54% male) were enrolled in the study. The mean age was 7.1 years (SD=2.0). The median visual analog scale measurement for dexamethasone was 8.2 cm (IQR= 5.2) whilst the median measurement for prednisolone was 5.0 cm (IQR= 7.3), p=0.03. Male children were more likely to prefer dexamethasone than females with a median score of 9.9 cm (IQR=3.8) for males vs. 5.9 cm (IQR=9.3) for females, p=0.005. There was no gender preference for prednisolone.
Conclusions
There was a statistically significant difference between the taste of dexamethasone and prednisolone, with dexamethasone being the preferred steroid among pediatric patients with asthma. Males were much more likely to prefer dexamethasone than females
References
2. Nowak RM, Tokarski G. Asthma. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Philadelphia: Mosby Elsevier, 2006:72-79.
3. Katherine Barber, ed. Canadian Oxford Dictionary. Thumb Index Edition. Oxford University Press, 1998:1046.
4. Chou JW, Decarie D, Dumont RJ, Ensom MH. Stability of dexamethasone in extemporaneously prepared oral suspensions. Can J Hosp Pharm 2001;54:96-101.
5. Matsui D, Barron A, Rieder MJ. Assessment of the palatability of antistaphylococcal antibiotics in pediatric volunteers. Ann Pharmacother 1996;30:586-8.
6. Sjovall J, Fogh A, Huitfeldt B, Karlsson G, Nylen O. Methods for evaluating the taste of paediatric formulations in children: a comparison between the facial hedonic method and the patients’ own spontaneous verbal judgement. Eur J Pediatr 1984;141:243-7.
7. Steele RW, Thomas MP, Begue RE. Compliance issues related to the selection of antibiotic suspensions for children. Pediatr Infect Dis J 2001;20:1-5.
8. Kim MK, Yen K, Redman RL, Nelson TJ, Brandos J, Hennes HM. Vomiting of liquid corticosteroids in children with asthma. Pediatr Emerg Care 2006;22:397- 401.
9. Mitchell JC, Counselman FL. A taste comparison of three different liquid steroid preparations: prednisone, prednisolone, and dexamethasone. Acad Emerg Med 2003;10:400-3.
10. Lucas-bouwman ME, Roorda RJ, Jansman FGA, Brand PLP. Crushed prednisone tablets or oral solution for acute asthma? Arch Dis Child 2001;84:347-8.
11. Hendeles L. Selecting a systemic corticosteroid for acute asthma in young children. J Pediatr 2003;142:S40-4.
12. Hutto CJ, Bratton TH. Palatability and cost comparison of five liquid corticosteroid formulations. J Pediatr Oncol Nurs 1999;16:74-7.
13. Isa JM, Wong GK, Teraoka SS, Sera MJ, Tsusuima MM, Yamamoto LG. Parental pediatric corticosteroid preferences. Am J Emerg Med 2001;19:29-31.
14. Qureshi F, Zaritsky A, Poirier MP. Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma. J Pediatr 2001;139:20-6.
15. Altamimi S, Robertson G, Jastaniah W, et al. Single-dose oral dexamethasone in the emergency management of children with exacerbations of mild to moderate asthma. Pediatr Emerg Care 2006;22:786-93