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Pediatrics. 2013 Oct;132(4):e810-6. doi: 10.1542/peds.2012-3746. Epub 2013 Sep 16.

Oral dexamethasone for bronchiolitis: a randomized trial.

Author information

1
Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar. dkmaa@hotmail.com.

Abstract

OBJECTIVE:

Determine whether dexamethasone treatment added to salbutamol reduces time to readiness for discharge in patients with bronchiolitis and possible asthma.

METHODS:

We compared efficacy and safety of dexamethasone, 1 mg/kg, then 0.6 mg/kg for 4 more days, with placebo for acute bronchiolitis in patients with asthma risk, as determined by eczema or a family history of asthma in a first-degree relative. All patients received inhaled salbutamol. Time to readiness for discharge was the primary efficacy outcome.

RESULTS:

Two hundred previously healthy infants diagnosed with bronchiolitis, median age 3.5 months, were enrolled. Five placebo recipients needed admission to intensive care unit during infirmary treatment (P = .02). Among 100 dexamethasone recipients, geometric mean time to readiness for discharge was 18.6 hours (95% confidence interval [CI], 14.9 to 23.1 hours); among 90 control patients, 27.1 hours (95% CI, 21.8 to 33.8 hours). The ratio, 0.69 (95% CI, 0.51 to 0.93), revealed a mean 31% shortening of duration to readiness for discharge favoring dexamethasone (P = .015). Twenty-two dexamethasone and 19 control patients were readmitted to the short stay infirmary in the week after discharge (P = .9). No hospitalizations or side effects were reported during 7 days of surveillance.

CONCLUSIONS:

Dexamethasone with salbutamol shortened time to readiness for infirmary discharge during bronchiolitis episodes in patients with eczema or a family history of asthma in a first-degree relative. Infirmary and clinic visits in the subsequent week occurred similarly for the 2 groups.

KEYWORDS:

bronchiolitis; dexamethasone therapy; length of stay; respiratory infections; respiratory syncytial virus

PMID:
24043283
DOI:
10.1542/peds.2012-3746
[Indexed for MEDLINE]

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