It is used in the treatment of many conditions, including rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive lung disease, croup, brain swelling, and along with antibiotics in tuberculosis. Idiopathic thrombocytopenic purpura, a decrease in numbers of platelets due to an immune problem, responds to 40 mg daily for four days; it may be administered in 14-day cycles. It is unclear whether dexamethasone in this condition is significantly better than other glucocorticoids. before and/or after some forms of dental surgery, such as the extraction of the wisdom teeth, an operation which often leaves the patient with puffy, swollen cheeks. Dexamethasone is commonly given as a treatment for croup in children, as a single dose can reduce the swelling of the airway to improve breathing and reduce discomfort. It is injected into the heel when treating plantar fasciitis, sometimes in conjunction with triamcinolone acetonide. It is useful to counteract allergic anaphylactic shock, if given in high doses. Clinical question: Are clinical outcomes for dexamethasone equivalent to currently recommended corticosteroids for the treatment of children with mild to moderate asthma exacerbations? Background: National and international guidelines uniformly agree that administration of a systemic corticosteroid is appropriate for children hospitalized with mild to moderate asthma exacerbations. Based on available literature, a 2007 update to an expert panel report developed by the National Asthma Education and Prevention Program recommended prednisone, methylprednisolone, or prednisolone at 1-2 mg/kg daily in two divided doses (maximum 60 mg/day). Recent small studies have begun to examine the use of dexamethasone in acute asthma exacerbations. The longer half-life of dexamethasone enables shorter treatment regimens, which can improve compliance. Additionally, its taste is considered superior compared to currently recommended corticosteroids. Study designs: Two meta-analyses of randomized controlled trials (RCT). Synopsis: Both groups searched Medline for RCTs using the search terms “dexamethasone” and “asthma”; additional search terms included “decadron” and “status asthmaticus.” Limiting the search to a pediatric population was achieved by either using appropriate medical subject heading terms or by using an age limiter of ≤18 years of age.
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