Beclomethasone dipropionate does not affect mucociliary clearance in patients with chronic obstructive lung disease

Aerosolized steroids may be implicated in the increased incidence of chest infections. To evaluate such a possibility, we utilized a double-blind study to investigate the acute effect of inhaled beclomethasone dipropionate on mucociliary clearance in 10 patients with chronic obstructive lung disease (5 receiving the drug and 5 placebo). Mucociliary clearance was measured by inhalation of a 99mTc-labelled albumin aerosol. The resulting radioactivity was recorded externally by a large-field gamma camera and dedicated computer for 3 consecutive hours without patient repositioning. After 1-hour baseline recording, the subjects inhaled from a commercial pressurized canister either beclomethasone dipropionate (250 micrograms) or vehicle alone. The recording was then continued for 2 more hours. No statistically significant difference was found in clearance rates throughout the entire period of observation between patients receiving beclomethasone and controls. The data suggest that mechanisms other than mucociliary function impairment are responsible for the increased incidence of chest infections which may accompany steroid treatment by the inhalatory route.