title: Randomised placebo controlled trial of nebulised corticosteroids in acute respiratory syncytial viral bronchiolitis.
abstract: OBJECTIVE
  To evaluate short and long term effects of giving nebulised budesonide early in respiratory syncytial viral (RSV) bronchiolitis.
  
  
  METHODS
  A multicentre randomised double blind placebo controlled trial.
  
  
  METHODS
  Infants admitted to hospital with their first episode of RSV positive bronchiolitis.
  
  
  METHODS
  Randomisation to receive either 1 mg of nebulised budesonide (Bud) or placebo (Pla) twice daily from admission until 2 weeks after discharge. Follow up was for 12 months.
  
  
  METHODS
  Duration of hospital admission, time taken to become symptom free, re-admission rates, general practitioner consultation rates, and use of anti-wheeze medication during follow up.
  
  
  RESULTS
  161 infants were studied. Both arms were similar with respect to initial clinical severity, age, sex, socioeconomic class, and tobacco exposure. Median time from first nebulisation to discharge: Bud and Pla, 2 days. Median number of days for 50% of infants to be symptom free for 48 hours: Bud, 10 days; Pla, 12 days. Respiratory re-admission rates in the 12 month follow up: Bud, 16%; Pla, 18%; median difference (95% confidence interval (CI)), -2 (-14 to 10). Median respiratory related general practitioner attendances: Bud, 4.0; Pla, 4.5; median difference (95% CI), -1 (-2 to 0). Percentage of infants receiving at least one prescription for anti-wheeze medication during follow up, corticosteroids: Bud, 50%; Pla, 60%; difference (95% CI), -10 (-26 to 6); bronchodilators: Bud, 60%; Pla, 67%; difference (95% CI), -7 (-22 to 8).
  
  
  CONCLUSIONS
  There are no short or long term clinical benefits from the administration of nebulised corticosteroids in the acute phase of RSV bronchiolitis.
authors.affiliation: Department of Paediatrics and Child Health, Clarendon Wing, Leeds General Infirmary, Belmont Grove, Leeds LS2 9NS, UK.
authors.forename: A
authors.initials: A
authors.lastname: Cade
authors.forename: K G
authors.initials: KG
authors.lastname: Brownlee
authors.forename: S P
authors.initials: SP
authors.lastname: Conway
authors.forename: D
authors.initials: D
authors.lastname: Haigh
authors.forename: A
authors.initials: A
authors.lastname: Short
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: D
authors.initials: D
authors.lastname: Dassu
authors.forename: S A
authors.initials: SA
authors.lastname: Mason
authors.forename: A
authors.initials: A
authors.lastname: Phillips
authors.forename: R
authors.initials: R
authors.lastname: Eglin
authors.forename: M
authors.initials: M
authors.lastname: Graham
authors.forename: A
authors.initials: A
authors.lastname: Chetcuti
authors.forename: M
authors.initials: M
authors.lastname: Chatrath
authors.forename: N
authors.initials: N
authors.lastname: Hudson
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: P A
authors.initials: PA
authors.lastname: Chetcuti
mesh_terms: D000208:Acute Disease; D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001990:Bronchiolitis, Viral / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide