Not All Oral Corticosteroids Are Created Equal for Children with Asthma

Most children with acute asthma exacerbations require oral corticosteroids for resolution of symptoms. Some liquid preparations are unpalatable, resulting in vomiting, the need to readminister medication, increased time in the emergency department, and treatment failure due to nonadherence. Orapred, a new prednisolone formulation that is commonly used in many EDs, has been touted by its manufacturer as being more palatable than other brands and less likely to cause vomiting.

In a randomized double-blind trial, investigators compared the incidence of vomiting with generic prednisolone and with Orapred in 188 children aged 2 to 10 years with acute asthma exacerbation. Taste, a secondary endpoint, was assessed in a subgroup of children older th…