Oral corticosteroids for wheezing attacks under 18 months

Abstract

In a double blind, partial crossover trial we compared treatment with prednisolone with treatment with placebo (56 treatments) in 38 children aged less than 18 months (mean age 9.8 months, range 3-17 months), 30 of whom had required previous admission to hospital. Placebo or oral prednisolone 2 mg/kg/day in two divided doses for five days was given during acute exacerbations of symptoms on an outpatient basis. Daily symptom scores of cough, wheeze, and breathlessness did not show any significant difference in rate of improvement or overall outcome, either between the two whole groups or within subgroups aged less than 6 months, 6-12 months, and 12-18 months. Parental preference failed to indicate superiority of treatment with prednisolone over treatment with placebo in the 18 crossover patients, and parents were equally as likely to feel that treatment with either placebo or prednisolone had had positive effect in non-crossover patients. Two children required admission to hospital during treatment, one aged 5 1/2 months being treated with prednisolone, and one aged 14 months being treated with placebo.