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

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: Jul 22, 2017
• 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
• Contract Date: Jul 10, 2017