A Comparison of the Effectiveness of Oral Prednisone Therapy Given at Different Frequencies among Pediatric Asthma Patients

"Purpose" Asthma is a common chronic disease that affects 334 millions of people of all ages in all parts of the world, with 14% of the world's children experiencing asthma symptoms. It is one of the most common causes of childhood emergency room visits, hospitalizations and missed school days. Despite a better understanding of the pathophysiology of the disease and the advancement in management, asthma prevalence and burden disability continue to rise, especially in developing countries. According to the Global Initiatives of Asthma guidelines of 2017, the recommended treatment of asthma exacerbation is short acting beta-2 agonists with or without ipratropium bromide and systemic corticosteroids. Patients who responded well to treatment are discharged on oral steroids usually in the form of prednisone at a dose of 1-2 mg/kg/day in 2 divided doses. However, it was observed that a lot of patients do not comply with the twice daily dosing. It is therefore the objective of this study to look into the feasibility of a once daily dosing of prednisone at 1-2 mg/kg/day for treatment of acute asthma exacerbation. "Methods" A total of 38 participants were included in the open-label observational study in a tertiary hospital. Baseline parameters were recorded using the pulmonary index scoring system. The participants were randomized into the twice daily and once daily dosing of prednisone therapy. Reassessment was done on the 3rd and 6th day follow-up.Data were analyzed using t-test for 2 independent samples, comparison of proportions of 2 independent samples, and analysis of variance. "Results" The demographic profile of the participants in both study groups were comparable. The clinical profile of the participants based on the pulmonary index scores were likewise comparable throughout the study period. There was significant recovery observed in both study groups with a p-value of 0.00. Adverse effects such as increased appetite and activity were observed but not statistically significant. Compliance to medication was similar in both study groups. "Conclusion" Oral prednisone therapy given once daily in the management of mild to moderate asthma exacerbation is equally as effective as the twice daily dosing schedule. Since compliance to treatment is an important factor in determining the success or failure of asthma therapy in an ambulatory care setting, a once daily dosing of prednisone therapy has the potential benefit of improving patient compliance with treatmen