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

Aljebab, Fahad; Alanazi, Mofadhi; Choonara, Imti; Conroy, Sharon

Authors

Fahad Aljebab

Mofadhi Alanazi

Imti Choonara

Sharon Conroy



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.

Citation

Aljebab, F., Alanazi, M., Choonara, I., & Conroy, S. (2018). Observational study on the palatability and tolerability of oral prednisolone and oral dexamethasone in children in Saudi Arabia and the UK. Archives of Disease in Childhood, 103(1), 83-88. https://doi.org/10.1136/archdischild-2017-312697

Journal Article Type Article
Acceptance Date Apr 15, 2017
Online Publication Date Jul 22, 2017
Publication Date 2018-01
Deposit Date Jul 10, 2017
Publicly Available Date Mar 28, 2024
Journal Archives of Disease in Childhood
Print ISSN 0003-9888
Electronic ISSN 1468-2044
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 103
Issue 1
Pages 83-88
DOI https://doi.org/10.1136/archdischild-2017-312697
Keywords Corticosteroid, Oral, Asthma, Croup, Taste, Adverse drug reaction
Public URL https://nottingham-repository.worktribe.com/output/873176
Publisher URL http://adc.bmj.com/content/early/2017/07/18/archdischild-2017-312697

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