The Recovery Trial: Effect of Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report

The findings of this well done randomized controlled trial indicate that in patients with COVID-19 pneumonia, that dexamethasone improves 28d mortality compared to placebo in patients requiring invasive mechanical ventilation (IMV) (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).

Steroids for Acute Asthma Exacerbation

A single dose of oral dexamethasone 12mg may be a reasonable alternative to a 5-day course of prednisone 60mg for adults with asthma exacerbations.

Bell’s Palsy…steroids! steroids! steroids!

From a recent Cochrane review, the available moderate- to high-quality evidence from randomised controlled trials showed significant benefit from treating Bell’s palsy with corticosteroids. Only 1 in 10 patients treated with corticosteroids will not recover fully (95% CI 6 to 20).

This is NOT a reason to give steroids…

Severe croup…

Try to KEEP THE CHILD CALM. Provide 5ml nebulized epinephrine (1:1000 concentration) and Steroids (PO is the way to go. However, in severe croup, use IM, or IV if available)  

Inhaled corticosteroids in the treatment of acute asthma DOES NOT WORK!

For those who still insist on nebulizing their acute asthmatics with inhaled steroids…PLEASE STOP…it doesn’t work and it’s a waste of the patient’s money

2 doses of dexamethasone is better than 5 days of Prednisone in Paediatric Acute Asthma disposition

Steroid Dosing & Conversion Chart

Please know your steroids…(and NO! They are NOT Antihypertensives)