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Published on: May 10, 2024

Parent-initiated oral corticosteroid therapy for intermittent wheezing illnesses in children: systematic review

Peter J Vuillermin1, Colin F Robertson, Mike South

  • 1Murdoch Children's Research Institute, and Department of Paediatrics, University of Melbourne, Melbourne, Australia. peterv@barwonhealth.org.au

Journal of Paediatrics and Child Health
|May 31, 2007
PubMed

Insights

Parent-initiated oral corticosteroids (PIOCS) show no clear benefit for children with intermittent wheezing illnesses. More research is needed to clarify the benefits and harms of PIOCS for childhood wheeze management.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Pharmacology

Background:

  • Intermittent wheezing illnesses, including viral-associated wheeze and asthma, are common pediatric urgent care presentations.
  • Parent-initiated oral corticosteroids (PIOCS) are sometimes used by parents to manage these conditions at home.

Purpose of the Study:

  • To systematically review the benefits and harmful effects of PIOCS in managing intermittent wheezing illness in children.
  • To evaluate the efficacy of PIOCS for common symptoms and healthcare utilization in pediatric wheezing.

Main Methods:

  • A systematic review of randomized clinical trials was conducted.
  • Searches included major databases (Cochrane, MEDLINE, EMBASE, etc.) for trials involving children aged 1-18 years with intermittent wheezing illnesses.
  • Two high-quality randomized clinical trials with 303 participants were included.

Main Results:

  • The included trials found no evidence that PIOCS improve hospital admissions or unscheduled medical reviews.
  • PIOCS did not demonstrate benefits in symptom scores or bronchodilator use.
  • Clinical heterogeneity between trials prevented meta-analysis.

Conclusions:

  • Current evidence on the benefits of PIOCS for childhood intermittent wheezing is limited and inconclusive.
  • While oral corticosteroids are established for acute asthma in hospitals, PIOCS use requires careful consideration.
  • PIOCS may be considered for severe asthma history with parental assessment capability, but widespread use is not recommended pending further evidence on benefits and harms.
Abstract

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