In: Dexamethasone, Out: Prednisone

Move over ketamine and TXA, there’s another medication gradually approaching do-it-all darling status in Emergency Medicine: dexamethasone.

Sore throats?

Croup?

Headaches?

Non-specific aches?

Well, yes to all of the above, in the appropriate clinical context –

But, most prominently, as featured in this brief report, for asthma – particularly childhood asthma.

It’s NHAMCS – so it is representative data being transformed into rough weighted estimates – between 2010-2021, but we see its use increasing from 3.5% of asthma visits to 17.3% – and the rates are over double that in children.

A heartening trend for a simpler administration and adherence strategy – and non-inferior, overall, while entirely reasonable to judiciously select a higher-risk patient in whom it might be plausible to prescribe prednisone/prednisolone instead.

“Trends in dexamethasone treatment for asthma in U.S. emergency departments”
https://onlinelibrary.wiley.com/doi/full/10.1111/acem.14997