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Should systemic corticosteroids be used for bronchiolitis?

Gonzalo Alarcón-Andrade1, Lorena Cifuentes2

  • 1Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.

Medwave
|May 12, 2018
PubMed

Insights

Systemic corticosteroids do not benefit children with bronchiolitis, a common viral respiratory infection. This conclusion applies even to infants requiring mechanical ventilation, indicating no therapeutic advantage.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Infectious Diseases

Background:

  • Bronchiolitis is a common viral infection causing acute inflammation of small airways in infants.
  • It predominantly affects children under two years, especially those under 12 months.
  • The efficacy of systemic corticosteroids for bronchiolitis treatment remains debated.

Purpose of the Study:

  • To evaluate the effectiveness of systemic corticosteroids in treating bronchiolitis.
  • To provide evidence-based recommendations for bronchiolitis management.

Main Methods:

  • Conducted a comprehensive search using Epistemonikos, a large database of systematic reviews.
  • Included data from multiple sources like MEDLINE, EMBASE, and Cochrane.
  • Performed a meta-analysis of 20 randomized trials from four systematic reviews, utilizing the GRADE approach.

Main Results:

  • Systemic corticosteroids demonstrated no significant benefit in treating bronchiolitis.
  • This finding was consistent even for patients requiring mechanical ventilation.

Conclusions:

  • Systemic corticosteroid therapy is not recommended for bronchiolitis treatment.
  • Current evidence does not support the use of corticosteroids in any pediatric bronchiolitis cases.
Abstract

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