WARSAW — A single intramuscular injection of 0.6 mg/kg dexamethasone decreased the duration of symptoms and hospital stay among young children with bronchiolitis in a randomized, placebo controlled trial, according to Jamaree Teeratakulpisarn, M.D.
The optimal treatment of acute bronchiolitis remains controversial, Dr. Teeratakulpisarn said.
Some reports in the literature suggest that corticosteroids may be helpful, and a single dose of dexamethasone has been shown to be beneficial in the treatment of croup.
“We therefore conducted a randomized, double-blind, placebo controlled trial in 174 children younger than 2 years hospitalized with acute bronchiolitis,” Dr. Teeratakulpisarn wrote in a poster session at an international congress of the World Society for Pediatric Infectious Diseases.
The primary outcome was time to symptom resolution, which was defined as a respiratory rate score of 0 or 1, wheezing score of 0 or 1, retraction muscle score of 0 or 1, and oxygen saturation of 95% or greater without oxygenation, the physician said.
Analysis showed that dexamethasone treatment was associated with a significant increase in favorable outcome—shorter duration of symptoms—with a hazard ratio of 1.56, compared with placebo, he said.
The treatment significantly decreased the mean duration of symptoms by 11.8 hours, duration of oxygen therapy by 16.6 hours, and length of hospital stay by 13.4 hours, reported Dr. Teeratakulpisarn of the department of pediatrics, Khon Kaen (Thailand) University.
There were very few minor side effects with the medication, and there were no significant differences between the active treatment group and the placebo group in additional drugs used, adverse effects, and complications, Dr. Teeratakulpisarn said.
This treatment should be recommended for acute bronchiolitis, Dr. Teeratakulpisarn concluded.