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Theophylline therapy in bronchiolitis. A retrospective study
Insights
Theophylline and steroid treatments did not improve outcomes for infants hospitalized with acute bronchiolitis or wheezing. This study suggests these therapies offer no significant benefit for young children with these respiratory conditions.
Area of Science:
- Pediatrics
- Pulmonology
- Clinical Pharmacology
Background:
- Bronchiolitis shares clinical and pathophysiologic similarities with asthma, leading to suggestions for bronchodilator drug use.
- The effectiveness of bronchodilator therapies in treating bronchiolitis remains unproven in scientific literature.
Purpose of the Study:
- To evaluate the effectiveness of theophylline, steroids, and inhaled sympathomimetic drugs in treating acute bronchiolitis or wheezing in infants.
- To compare treatment outcomes between infants who received these therapies and those who did not.
Main Methods:
- A retrospective review of 64 children under 18 months hospitalized for their first episode of bronchiolitis or wheezing.
- Comparison of outcomes between a group of 31 patients receiving theophylline (with or without steroids/sympathomimetics) and a control group of 34 patients receiving no such therapy.
Main Results:
- No significant differences in clinical findings, laboratory assessments, or treatment outcomes were observed between the theophylline-treated and untreated groups.
- The theophylline-treated group was older (9.4 vs. 4.9 months), but this did not appear to influence the lack of observed benefit.
Conclusions:
- Theophylline and steroid therapies demonstrated no beneficial effects on the resolution of acute bronchiolitis or wheezing in the majority of infants and small children studied.
- Current evidence does not support the routine use of theophylline, steroids, or sympathomimetics for treating acute bronchiolitis or wheezing in infants.
Abstract:
Since bronchiolitis has clinical and pathophysiologic similarities to asthma, the use of bronchodilator drugs has been suggested; however, their effectiveness remains unproven. We reviewed the outcome of treatment in 64 children less than 18 months of age hospitalized for the first time with a diagnosis of bronchiolitis or wheezing. Thirty one of the patients received theophylline therapy and sometimes steroids and/or inhaled sympathomimetic drugs, and 34 received no such therapy. Although the theophylline-treated children were older (9.4 vs 4.9 months of age), there were no other differences in the histories, clinical findings, laboratory assessments, or outcome between theophylline-treated and untreated groups. The results suggest that theophylline and steroid therapies had not beneficial effects on the resolution of acute bronchiolitis or wheezing in the majority of infants and small children.