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Efficacy of oral dexamethasone in outpatients with acute bronchiolitis

Suzanne Schuh1, Allan L Coates, Rosemary Binnie

  • 1Divisions of Emergency, Respiratory Medicine, and Paediatric Medicine, the Paediatric Outcomes Research Team and Research Institute, The Hospital for Sick Children, and the Department of Pediatrics, University of Toronto, Ontario, Canada.

The Journal of Pediatrics
|January 30, 2002
PubMed

Insights

Oral dexamethasone significantly improved outcomes for infants with acute bronchiolitis. This treatment reduced the need for hospitalization and improved clinical scores within the first four hours of therapy.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Pharmacology

Background:

  • Acute bronchiolitis is a common viral respiratory infection in infants.
  • Current treatments are primarily supportive, with limited pharmacological interventions demonstrating efficacy.
  • The role of corticosteroids in managing bronchiolitis remains a subject of investigation.

Purpose of the Study:

  • To evaluate the effectiveness of a single oral dose of dexamethasone in treating acute bronchiolitis in young children.
  • To assess the impact of dexamethasone on clinical scores and hospitalization rates.

Main Methods:

  • A double-blind, randomized, placebo-controlled trial was conducted with 70 children under 24 months old.
  • Participants presented to the emergency department with moderate-to-severe acute bronchiolitis (Respiratory Disease Assessment Instrument score ≥ 6).
  • Children received either oral dexamethasone (1 mg/kg) or a placebo, with assessments every hour for 4 hours using the Respiratory Assessment Change Score (RACS).

Main Results:

  • The dexamethasone group showed a significantly greater improvement in RACS compared to the placebo group (P = .029).
  • Fewer children in the dexamethasone group experienced poor RACS (17% vs. 41%, P = .034).
  • Hospitalization rates were lower in the dexamethasone group (19%) compared to the placebo group (44%, P = .039).

Conclusions:

  • Oral dexamethasone provides significant clinical benefits for outpatients with moderate-to-severe acute bronchiolitis.
  • Dexamethasone treatment in the initial 4 hours led to a reduced need for hospitalization.
  • No significant difference in RACS was observed between groups by day 7.
Abstract

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