Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection-induced lower airway disease: a randomized, placebo-controlled trial☆
Section snippets
Study population
Children age 6 to 35 months were eligible for the study if, at the time of presentation to the pediatric emergency department (ED) of Tampere University Hospital, they had acute tachypnea, wheezing, or use of accessory respiratory muscles in the presence of an apparent viral respiratory infection (rhinorrhea or temperature >37.5°C).18 Patients were not eligible if they had asthma (documented diagnosis or a history of two or more previous physician-diagnosed wheezing episodes), inspiratory
Results
Between April 1997 and March 1999, a total of 603 acutely wheezing children 6 to 35 months old with no previous diagnosis of asthma attended the ED at Tampere University Hospital. Of these, 136 had two or more previous wheezing episodes and thus were not eligible for inclusion. For the remaining 467 children, the trial profile is illustrated in Figure 1.
There was no major difference in baseline characteristics between the two intervention arms (Table I) or between children hospitalized and not
Discussion
This study demonstrated that children 6 to 35 months old with virally induced respiratory distress benefited from a 3-day course of oral prednisolone treatment. Those given the active preparation had fewer symptomatic days, were less likely to receive additional asthma medication, and were more likely to be discharged.
The beneficial effect of oral prednisolone was independent of the child's earlier wheezing history. However, first-time wheezers were less likely to need additional asthma
Acknowledgements
We give special thanks to the parents of the children and to the staff of the Pediatric Department or Tampere University Hospital. Without their cooperation, this investigation could have never been accomplished.
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Supported by grants from the Emil Aaltonen Foundation; the Finnish Allergy Research Foundation; the Foundation for Pediatric Research, Finland; the Medical Research Fund of Tampere University Hospital; the Support Fund for the Department of Pediatrics; the Tampere University Research Foundation; and the Tuberculosis Foundation of Tampere.