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Inhaled corticosteroids during and after respiratory syncytial virus-bronchiolitis may decrease subsequent asthma
M Kajosaari1, P Syvänen, M Förars
1Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland.
Summary
Inhaled corticosteroid treatment for infants with respiratory syncytial virus (RSV) bronchiolitis may reduce later asthma and wheezing. This treatment during and after the acute infection appears beneficial for long-term respiratory health.
Area of Science:
- Pediatrics
- Pulmonology
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) bronchiolitis in infants can lead to long-term respiratory issues like bronchial hyper-reactivity and recurrent obstructive bronchitis.
- Understanding the impact of different treatment strategies on the post-bronchiolitis respiratory status is crucial for infant health.
Purpose of the Study:
- To investigate the influence of varying inhaled corticosteroid treatment durations on the respiratory outcomes of infants hospitalized with RSV bronchiolitis.
- To assess the long-term effects of treatment on the development of asthma and wheezing tendencies.
Main Methods:
- A randomized controlled trial involving 117 infants (mean age 2.6 months) treated for RSV bronchiolitis.
- Three groups received standard symptomatic treatment: Group I (control), Group II (7-day inhaled budesonide), and Group III (2-month inhaled budesonide).
- Follow-up included clinical check-ups at 2 and 6 months, and telephone contact at 2 years post-infection.
Main Results:
- A statistically significant difference in asthma prevalence was observed between the groups.
- Asthma rates were 37% in the control group, 18% in the 7-day budesonide group, and 12% in the 2-month budesonide group.
- Longer-term inhaled corticosteroid treatment showed a reduced tendency for subsequent bronchial wheezing.
Conclusions:
- Inhaled corticosteroid therapy during and after the acute phase of infant RSV bronchiolitis may positively impact the subsequent tendency for bronchial wheezing.
- Extended treatment with inhaled budesonide appears more effective in mitigating long-term respiratory sequelae.
- These findings suggest a potential therapeutic role for inhaled corticosteroids in managing RSV bronchiolitis to prevent chronic respiratory issues.