title: Oral dexamethasone for bronchiolitis: a randomized trial.
abstract: OBJECTIVE
  Determine whether dexamethasone treatment added to salbutamol reduces time to readiness for discharge in patients with bronchiolitis and possible asthma.
  
  
  METHODS
  We compared efficacy and safety of dexamethasone, 1 mg/kg, then 0.6 mg/kg for 4 more days, with placebo for acute bronchiolitis in patients with asthma risk, as determined by eczema or a family history of asthma in a first-degree relative. All patients received inhaled salbutamol. Time to readiness for discharge was the primary efficacy outcome.
  
  
  RESULTS
  Two hundred previously healthy infants diagnosed with bronchiolitis, median age 3.5 months, were enrolled. Five placebo recipients needed admission to intensive care unit during infirmary treatment (P = .02). Among 100 dexamethasone recipients, geometric mean time to readiness for discharge was 18.6 hours (95% confidence interval [CI], 14.9 to 23.1 hours); among 90 control patients, 27.1 hours (95% CI, 21.8 to 33.8 hours). The ratio, 0.69 (95% CI, 0.51 to 0.93), revealed a mean 31% shortening of duration to readiness for discharge favoring dexamethasone (P = .015). Twenty-two dexamethasone and 19 control patients were readmitted to the short stay infirmary in the week after discharge (P = .9). No hospitalizations or side effects were reported during 7 days of surveillance.
  
  
  CONCLUSIONS
  Dexamethasone with salbutamol shortened time to readiness for infirmary discharge during bronchiolitis episodes in patients with eczema or a family history of asthma in a first-degree relative. Infirmary and clinic visits in the subsequent week occurred similarly for the 2 groups.
authors.affiliation: Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar. dkmaa@hotmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alansari
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Sakran
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Davidson
authors.forename: Khalid
authors.initials: K
authors.lastname: Ibrahim
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Alrefai
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Zakaria
mesh_terms: D000284:Administration, Oral; D000420:Albuterol / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001988:Bronchiolitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010351:Patient Discharge / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D000420:Albuterol
keywords: bronchiolitis; dexamethasone therapy; length of stay; respiratory infections; respiratory syncytial virus