title: Effectiveness of nebulized beclomethasone in preventing viral wheezing: an RCT.
abstract: OBJECTIVE
  The goal of this study was to evaluate the effectiveness of nebulized beclomethasone in preventing the recurrence of viral wheezing.
  
  
  METHODS
  The study was designed as a randomized, double-blind, placebo-controlled trial. Outpatient children aged 1 to 5 years with at least 1 episode of viral wheezing in the last 12 months, presenting to any of 40 Italian pediatricians for an upper respiratory tract infection, were randomly allocated to receive beclomethasone 400 μg or placebo twice daily for 10 days. Medications were administered through a nebulizer. A clinical evaluation was performed by the pediatrician at the start and end of the treatment period. A subjective evaluation of symptoms and efficacy of treatment was performed by the parents. The primary endpoint was the incidence of viral wheezing diagnosed by the pediatricians during the 10-day treatment period.
  
  
  RESULTS
  A total of 525 children were enrolled in the study, 521 of whom were visited at the end of the treatment period. Wheezing was diagnosed by the pediatricians in 47 children (9.0% [95% confidence interval: 6.7 to 11.3]), with no statistically significant differences between treatment groups (beclomethasone versus placebo relative risk: 0.61 [95% confidence interval: 0.35 to 1.08]).The treatment was considered helpful by 63% of parents (64% in the beclomethasone group vs 61% in the placebo group). In all, 46% of children still had infection symptoms at the end of the treatment period, with no differences between groups.
  
  
  CONCLUSIONS
  The findings from this study confirm that inhaled steroids are not effective in preventing recurrence of viral wheezing. Moreover, no benefits were found in reducing symptoms of respiratory tract infections.
authors.affiliation: Laboratory for Mother and Child Health, Department of Public Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Clavenna
authors.forename: Marco
authors.initials: M
authors.lastname: Sequi
authors.forename: Massimo
authors.initials: M
authors.lastname: Cartabia
authors.forename: Filomena
authors.initials: F
authors.lastname: Fortinguerra
authors.forename: Marta
authors.initials: M
authors.lastname: Borghi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bonati
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001507:Beclomethasone / Q000008:administration & dosage*; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers; D012135:Respiratory Sounds / Q000175:diagnosis / Q000187:drug effects*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D001507:Beclomethasone
keywords: beclomethasone; physicians; preschool-aged child; primary care; randomized controlled trial