Oral Dexamethasone for Pediatric Use

Primary Indication: Acute Asthma Exacerbations

• The American Academy of Pediatrics recommends ensuring parents understand to return if symptoms worsen or fail to improve within 48-72 hours 1

Emergency Department Dosing Guidelines

• For adrenal insufficiency, the American Academy of Pediatrics recommends IV/IO: 2-3 mg/kg (maximum 100 mg) over 3-5 minutes, followed by 1-5 mg/kg every 6 hours for infants OR 12.5 mg/m² every 6 hours for older children 2, 3
• For postextubation upper airway obstruction prevention, the American Thoracic Society recommends administering dexamethasone at least 6 hours before extubation in children at high risk 4

Conditions Where Dexamethasone is NOT Recommended

• The American College of Chest Physicians states that dexamethasone provides no benefit for pertussis-associated cough, non-specific cough in children, and wheeze without asthma 5, 6