ORAL montelukast versus inhaled beclomethasone in the prophylactic treatment of post ACUTE viral bronchiolitis wheezing

Abstract

Objective: We aim to determine the potential benefit of inhaled beclomethasone dipropionate (BDP) and oral montelukast (MK) in the natural history of post acute viral bronchiolitis (AVB). Materials and Methods: This is an open, prospective, randomized, parallel control study, involving infants of 1 year of age or younger hospitalized for AVB. All patients with moderate-severe bronchiolitis (Wang score equal or superior to 8) were eligible for the study. Sixty seven infants diagnosed with ABV between July 2013 and May 2015 were selected for the study. Thirty children were excluded either because they fulfilled exclusion criteria or lost their follow up. At hospital discharge, recruited patients were randomly assigned into 3 study groups: no drug, MKor BDP and schedule for monthly follow-up appointments for 6 months. The primary variables were: need for readmission and number of visits to the emergency department (ED). Secondary variables were: number of asymptomatic days and need of bronchodilator and/or oral corticosteroid. Results: The analysis was performed on 37 children, 12 randomized to receive no prophylaxis, 18 randomized to MK and 7 to use BDP. There were 3 hospitalizations in children with no prophylaxis and 3 receiving MK. There were no readmissions in the group receiving BPD. Visits to ED occurred in 6 children with no prophylaxis, 15 in those receiving MK and in 6 children receiving BPD. There was no statistics difference between the groups considering readmission, visit to the ED, asymptomatic days after discharge, bronchodilator and oral corticosteroids use. Conclusions: Our study showed no benefit of MK or BPD in the treatment of post AVB. A larger number of patients will allow us to establish more reliable statistical data.