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Long‐term effects of prednisolone in the acute phase of bronchiolitis caused by respiratory syncytial virus
Author(s) -
Woensel J.B.M. van,
Kimpen J.L.L.,
Sprikkelman A.B.,
Ouwehand A.,
Aalderen W.M.C. van
Publication year - 2000
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/1099-0496(200008)30:2<92::aid-ppul3>3.0.co;2-x
Subject(s) - medicine , bronchiolitis , prednisolone , asthma , placebo , pediatrics , pneumovirus , respiratory system , immunology , virus , viral disease , paramyxoviridae , pathology , alternative medicine
Follow‐up studies have demonstrated that bronchiolitis caused by respiratory syncytial virus (RSV) is strongly associated with wheezing in the ensuing years. During the acute infection the immune response may induce long‐lasting detrimental effects, thereby contributing to post‐bronchiolitis wheezing (PBW). Therefore, immune‐modulating drugs like corticosteroids, administered in the acute phase of RSV bronchiolitis, may prevent PBW and asthma. To evaluate this, we performed a controlled prospective follow‐up study after a randomized double‐blind placebo‐controlled intervention in the acute phase with oral prednisolone. Fifty‐four patients under 2 years of age and hospitalized for RSV bronchiolitis between 1992 and 1995 were randomly assigned to prednisolone 1 mg/kg/day for 7 days or placebo. At the mean age of 5 years, 47 patients had completed their follow‐up. Patients were divided into four groups: no wheezing, transient wheezing (wheezing during the first year of life); persistent wheezing (wheezing during the first year of life and asthma at the age of 5); and late‐onset wheezing (no wheezing during the first year of life but asthma at the age of 5). Prevalence of wheezing and asthma were investigated through an interview by telephone, using a standardized questionnaire. We found no significant differences between the prednisolone‐ and the placebo‐treated group in the number of patients with transient wheezing (8% vs. 17%), persistent wheezing (42% vs. 31%), or late‐onset wheezing (17% vs. 13%). We conclude that oral prednisolone during the acute phase of RSV bronchiolitis is not effective in preventing PBW or asthma at the mean age of 5 years. Pediatr Pulmonol. 2000; 30: 92–96. © 2000 Wiley‐Liss, Inc.