Oral prednisone as a risk factor for infections in children with asthma
C. C. Grant, A. K. Duggan, M. Santosham and C. DeAngelis
Division of General Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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. CONCLUSIONS: 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.
