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Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years: randomised controlled trial
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Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years: randomised controlled trial
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Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years: randomised controlled trial
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Journal Article
Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years: randomised controlled trial
2003
Overview
Episodic wheeze triggered by viral colds is common in children aged between 1 and 5 years (preschool viral wheeze). Most affected children are asymptomatic by age 6 years. Persistence of wheeze is associated with above-average systemic eosinophil priming. Use of parental-initiated oral prednisolone is recommended at the first sign of preschool viral wheeze. However, evidence for this treatment strategy is conflicting. We therefore aimed to assess the efficacy of a short course of oral prednisolone for preschool viral wheeze, with stratification for systemic eosinophil priming.
Children aged 1–5 years admitted to hospital with viral wheeze were allocated to either a high-primed or low-primed stratum according to amounts of serum eosinophil cationic protein and eosinophil protein X, and randomised to parent-initiated prednisolone (20 mg one daily for 5 days) or placebo for the next episode. The primary outcomes were the 7-day mean daytime and night-time respiratory symptom scores, which were analysed by mean differences between treatment groups.
108 children were randomised to placebo and 109 to prednisolone. Outcome data were available for 120 (78%) of 153 children who had a further episode of viral wheeze, of whom 51 received prednisolone and 69 placebo. Mean daytime (difference in means −0·01 [−0·22 to 0·20]) and night-time (0·10 [−0·12 to 0·32]) respiratory symptom scores and need for hospital admission did not differ between treatment groups. Within the high-primed (n=59) and low-primed (n=61) strata there was no difference in primary outcome between treatment groups.
There is no clear benefit of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1–5 years even in those with above-average eosinophil priming.
Publisher
Elsevier Ltd,Lancet,Elsevier Limited
Subject
/ Adrenal Cortex Hormones - administration & dosage
/ Adrenal Cortex Hormones - therapeutic use
/ Age
/ Anti-Inflammatory Agents - administration & dosage
/ Anti-Inflammatory Agents - therapeutic use
/ Asthma
/ Biological and medical sciences
/ Child
/ Children
/ Colds
/ Daytime
/ Drug Administration Schedule
/ Eosinophil-Derived Neurotoxin
/ Humans
/ Infant
/ Night
/ Pharmacology. Drug treatments
/ Prednisolone - administration & dosage
/ Prednisolone - therapeutic use
/ Priming
/ Proteins
/ Respiratory Sounds - drug effects
/ Viruses
