CLINICAL EFFICACY OF DEXAMETHASONE VERSUS HYDROCORTISONE IN ACUTE EXACERBATION OF ASTHMA IN CHILDREN

Background: Asthma is a prevalent chronic respiratory condition among children worldwide, significantly impacting their health, quality of life, and healthcare systems. Acute exacerbations of asthma require prompt and effective management to reduce morbidity. Objective: To compare the clinical efficacy and safety of dexamethasone versus hydrocortisone in children with acute asthma exacerbations. Study Design: Randomized controlled trial. Setting: Emergency Pediatric Medicine Department and General Medical Ward of the Children's Hospital, Lahore. Duration of Study: November 2023 to April 2024. Methods: Children aged 6–15 years presenting with acute asthma exacerbations were enrolled and randomly assigned to receive either dexamethasone or hydrocortisone. Baseline characteristics, including age, gender, weight, respiratory rate, oxygen saturation, asthma history duration, and initial FEV1, were recorded. The primary outcomes assessed included changes in respiratory parameters, duration of respiratory support, and length of hospital stay. Results: The study included 110 participants, with 55 patients in each group. The mean age was 9.5±3.45 years in the dexamethasone group and 9.4±2.91 years in the hydrocortisone group. Both groups showed comparable gender distribution (60% male and 58% male, respectively) and baseline characteristics. The mean respiratory rate was 32±4.2 bpm in the dexamethasone group versus 31±4.1 bpm in the hydrocortisone group, while oxygen saturation was 94±2% versus 93±2.4%, respectively. The mean hospital stay was shorter in the dexamethasone group (3.1±0.9 days) compared to the hydrocortisone group (3.6±1.1 days). Dexamethasone demonstrated faster improvement in respiratory parameters and earlier cessation of respiratory support. Conclusion: Dexamethasone is a more effective and convenient option than hydrocortisone for managing acute asthma exacerbations in children, offering faster clinical improvement and shorter hospital stays.