Placebo controlled trial of systemic corticosteroids in acute childhood asthma.
In a randomised controlled trial 38 asthmatic children aged 2-11 yr who had not received regular oral or inhaled steroids during the previous year, were treated with a standard regime of nebulised salbutamol and intravenous aminophylline plus either hydrocortisone and oral prednisolone for 5 days, or placebo. The children were observed throughout their hospital stay and for 3 months afterwards. There was a greater fall in heart rates in the steroid treated group on the second day of treatment (mean diff. 16 beats/min) and at discharge (mean diff. 13 beats/min); p less than 0.025. Peak Expiratory Flow Rates recorded in 26 children, 13 in each group, showed more improvement on day 2 in those given steroids (mean diff 16% predicted); p less than 0.05. This difference was not apparent at discharge but 9 children treated with steroids were clinically wheeze-free when they left hospital compared with 3 in the placebo group, p less than 0.05. There were no differences in respiratory rate, pulsus paradoxus and arterial oxygen saturation. Trends in duration of hospital stay and relapse rate during the succeeding 3 months favoured active treatment. These findings support the use of systemic corticosteroids in addition to high dose bronchodilators to treat 'non steroid dependent' children hospitalised with acute severe asthma.
Gleeson
J G
JG
Department of Paediatrics, King's College Hospital, London, UK.
Loftus
B G
BG
Price
J F
JF
D000208:Acute Disease; D000420:Albuterol / Q000494:pharmacology / Q000627:therapeutic use; D000628:Aminophylline / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D010100:Oxygen / Q000097:blood; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D010919:Placebos; D011239:Prednisolone / Q000494:pharmacology / Q000627:therapeutic use*
D010919:Placebos; D000628:Aminophylline; D011239:Prednisolone; D000420:Albuterol; D010100:Oxygen; D006854:Hydrocortisone