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Oral dexamethasone improved respiratory distress in children <2 years of age with acute bronchiolitis

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 QUESTION: In children <2 years of age who present to the emergency department (ED) with acute bronchiolitis, what is the effectiveness of oral dexamethasone?


Randomised (allocation concealed*), blinded (clinicians, patients, data collectors, and outcome assessors),* placebo-controlled trial with follow up at 4 hours and 7 days.


The ED of a hospital in Toronto, Ontario, Canada.


71 children who were between 8 weeks and 23 months of age, had a first wheezing episode associated with respiratory distress and an upper respiratory tract infection, and had a Respiratory Disease Assessment Instrument rating ≥6. Follow-up was 99% at 4 hours (mean age 6.5 mo, 61% boys) and 94% at 7 days.


36 children were allocated to a single dose of oral dexamethasone, 1 mg/kg, and 34 were allocated to placebo. At 0, 30, 60, and 120 …

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  • Sources of funding: Medical Research Council of Canada and Merck Frosst Canada.

  • For correspondence: Dr S Schuh, The Hospital for Sick Children, Toronto, ON, Canada. Email suzanne.schuh{at}

  • * See glossary.