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Guidance for GPs on giving children inhaled steroids

3 June 2008

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GPs are to be given detailed guidance on the prescribing of inhaled steroids in children after high doses resulted in a number of deaths.

The number of children between the ages of five and 12 being given high-dose inhaled steroids rose from 1.1% in 1992 to 4.6% in 2004, figures from the General Practice Research Database (GPRD) show. Over the same period, there was a fall – from 10.6% to 4.5% – in prescriptions of high-dose therapy for the under-5s.

The trend has prompted the publication of new guidance this summer by the General Practice Airways Group (GPAG) which will include detailed advice on “off-label” prescribing of the steroids.

“The dangers of high-dose ICS in children has become more apparent recently after a number of high-profile deaths in the UK, due to adrenal suppression,” study leader Dr Mike Thomas told the magazine Pulse.

He said that high doses of inhaled steroids left children more likely to develop side-effects, which could ultimately lead to death.

“The fact is that this is off-licence. If a GP does prescribe that and a patient comes to harm, it would be very hard to mount a rational defence,” he said.

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General Practice Research Database