Observational study on the palatability and tolerability of oral prednisolone and oral dexamethasone in children in Saudi Arabia and the United Kingdom

Aljebab, Fahad and Alanazi, Mofadhi and Choonara, Imti and Conroy, Sharon (2017) Observational study on the palatability and tolerability of oral prednisolone and oral dexamethasone in children in Saudi Arabia and the United Kingdom. Archives of Disease in Childhood . ISSN 1468-2044

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Abstract

Background: Short-course oral corticosteroids are routinely used to treat acute asthma and croup. We evaluated their tolerability and palatability in Saudi Arabian (SA) and UK children.

Methods: Prospective observational/interview study (three months in each country). Palatability was evaluated using a five-point facial scale and tolerability by direct questioning of patient/parents.

Results: In SA, of 122 patients (2–10years) recruited: 52 received prednisolone base tablets; 37 prednisolone sodium phosphate syrup; 33 dexamethasone elixir. In the UK, of 133 patients (2–16years): 38 received prednisolone base tablets (mainly crushed and dispersed); 42 prednisolone sodium phosphate soluble tablets; 53 dexamethasone sodium phosphate oral solution.

In both countries dexamethasone had the highest palatability scores (SA mean: 1.97; UK mean: 3) and prednisolone base tablets the lowest (SA mean: 1.12; UK mean: 1.39). Palatability scores improved for all formulations of prednisolone with each subsequent daily dose.

In SA prednisolone base tablets were associated with more nausea (24 vs 7 patients) and vomiting (5 vs 0) than sodium phosphate syrup (P=0.008 and P=0.073 respectively). In the UK vomiting occurred more frequently with prednisolone base (8) than sodium phosphate soluble tablets (2) (P=0.041).

In both centres dexamethasone was associated with less side effects. Vomiting (1 vs 0 patients), nausea (7 vs 3) and abdominal pain (10 vs 8) occurred more with dexamethasone sodium phosphate solution than dexamethasone elixir.

Conclusions: Dexamethasone sodium phosphate solution was the most palatable preparation. Prednisolone base tablets were rated least palatable and were least well tolerated. Palatability scores improved with each dose taken.

Item Type: Article
Keywords: Corticosteroid, Oral, Asthma, Croup, Taste, Adverse drug reaction
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Medical Sciences and Graduate Entry Medicine
Identification Number: 10.1136/archdischild-2017-312697
Depositing User: Eprints, Support
Date Deposited: 10 Jul 2017 10:11
Last Modified: 23 Aug 2017 01:22
URI: http://eprints.nottingham.ac.uk/id/eprint/44067

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