Dexamethasone inhalations in RSV bronchiolitis: a double-blind, placebo-controlled study.
OBJECTIVE
To evaluate the effect of inhaled dexamethasone on hospitalization for respiratory syncytial virus (RSV) bronchiolitis.


METHODS
A double-blind, placebo-controlled study compared nebulization of dexamethasone versus nebulization of 0.9% saline. Both groups were treated with epinephrine nebulizations. Follow-up continued for 3 mo.


METHODS
Sixty-one infants with bronchiolitis aged 3 to 12 mo were included. They were randomly allocated to nebulizations with 0.25 mg dexamethasone every 6 h (group 1) or an equivalent amount of normal saline (group 2).


RESULTS
No statistically significant differences with respect to clinical score, oxygen saturation, or IV fluid requirement between the groups were noted. Using Kaplan-Meyer's method, the cumulative proportion of in-hospital stay was significantly lower in group 1 compared with group 2, mainly in days 5 and 6 post-hospitalization (p<0.038). A subgroup of prematurely born children in group 1 had a shorter hospitalization period (6.5+/-1.7 d) compared with group 2 children (9.1+/-1.9) (p<0.018). Follow-up revealed similar wheeze and hospitalization rates in the two groups.


CONCLUSIONS
Inhaled dexamethasone may reduce the length of hospitalization among infants with acute viral bronchiolitis, especially among those born prematurely.
Bentur
Lea
L
Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. l_bentur@rambam.health.gov.il
Shoseyov
David
D
Feigenbaum
David
D
Gorichovsky
Yilena
Y
Bibi
Haim
H
D000280:Administration, Inhalation; D001990:Bronchiolitis, Viral / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D007902:Length of Stay; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*
D005938:Glucocorticoids; D003907:Dexamethasone; D004837:Epinephrine