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Which course of dexamethasone?
  1. F H BLOOMFIELD,
  2. D B KNIGHT,
  3. J E HARDING
  1. Department of Paediatrics, National Women’s Hospital
  2. Claude Road, Auckland, Private Bag 92019
  3. New Zealand

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    Editor—Skelton et al 1 state that “most units start [dexamethasone] by the second week of life, weaning over 2–3 weeks rather than 6” and that such a regimen “has been shown to be comparable in effectiveness with a six week course.” The reference cited is a review paper that provides no evidence for the first statement, and discusses studies that showed a benefit in time to extubation but not in the duration of oxygen treatment.2Time of extubation is irrelevant if the incidence of chronic lung disease has not been reduced, and, to our knowledge, a three week course has not been shown to have this beneficial effect. Indeed, Cummings et al, in the study in which he reported beneficial effects of the 6 …

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      BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health