Children with rhinovirus who received oral prednisolone suffered significantly less recurrent wheezing compared with children with respiratory syncytial virus who also received the steroid or children who received placebo.
Dr. Tuomas Jartti, of the department of pediatrics at Turku (Finland) University Hospital, and associates analyzed 78 children aged 3–35 months who completed hospitalization for rhinovirus (40 children) or respiratory syncytial virus (RSV) infections (38 children). The children were randomized to receive an initial oral dose of 2 mg/kg prednisolone, followed by 2 mg/kg per day in three divided doses for 3 days (46 patients), or placebo (32 patients). The children with rhinovirus were significantly more likely to be older, atopic, and recurrent wheezers, and they had significantly higher blood eosinophil levels and exhaled nitric oxide levels than did the children with RSV (Pediatr. Infect. Dis. J. 2006;25:482–8). Children in the RSV group were significantly more likely to have acute otitis media and to have been treated with antibiotics than were those in the rhinovirus group.
Children with rhinovirus or RSV who received oral prednisolone did not leave the hospital more quickly than children in the placebo group (22 hours vs. 30 hours).
By reducing recurrent wheezing, prednisolone use significantly decreased the need for outpatient visits in children with rhinovirus infections—but not in children with RSV infections—compared with children who received placebo.
“We speculate that an early asthma-like inflammation could explain the beneficial effect of prednisolone in the rhinovirus group,” the investigators said.
Prednisolone was well tolerated; no significant adverse events were reported.