January 1996

Oral Prednisone as a Risk Factor for Infections in Children With Asthma

Author Affiliations

From the Division of General Pediatrics, The Johns Hopkins University School of Medicine (Drs Grant, Duggan, and DeAngelis), and the Center for American Indian and Alaskan Native Health, The Johns Hopkins University School of Hygiene and Public Health (Dr Santosham), Baltimore, Md. Dr Grant is now in the Department of Paediatrics, University of Auckland (New Zealand) School of Medicine.

Arch Pediatr Adolesc Med. 1996;150(1):58-63. doi:10.1001/archpedi.1996.02170260062010

Objective:  To determine whether the frequency of acute infections in children with asthma is associated with the number of doses of prednisone received for asthma attacks.

Design:  A cohort study.

Setting:  Primary care clinic and emergency department of an inner-city teaching hospital from March 31, 1992, to May 31, 1993.

Patients:  Convenience sample of clinic enrollees aged 2 to 14 years who had made two or more outpatient visits for acute asthma in the preceding year. Eighty-six children were enrolled. Seventy-eight (91%) completed the study.

Main Outcome Measures:  The independent variable was cumulative prednisone dose received during the study period. Outcome variables were episodes of acute infections.

Results:  The mean (±SD) number of doses of prednisone (2 mg/kg to a maximum of 60 mg) received was 9.5±11.8 doses (range, 0 to 57 doses). Ninety-four episodes of acute infection occurred in 50 children. No difference was observed in the mean number of doses of prednisone received by those with the infection compared with those without the infection. No correlation was observed between the number of doses of prednisone received and the number of episodes of each infection.

Conclusion:  The administration of prednisone as short courses for acute asthma is not associated with an increase in the number of episodes of common acute infections.(Arch Pediatr Adolesc Med. 1996;150:58-63)