Prednisolone May Prevent Recurrent Wheeze in Children

Short-course treatment may be beneficial for first wheezers with rhinovirus infection or eczema

MONDAY, April 9 (HealthDay News) -- A short course of oral prednisolone may help prevent recurrent wheezing in infants and young children with a first episode of wheezing associated with rhinovirus infection or eczema, but not respiratory syncytial virus or other pathogens, according to the results of a randomized trial published in the March issue of the Journal of Allergy and Clinical Immunology.

Pasi Lehtinen, M.D., of the University of Turku in Finland, and colleagues conducted a follow-up study of 118 children (median age, 1.1 years) who were randomized to a short course of oral prednisolone or placebo after a first episode of wheezing.

The researchers found that prednisolone was associated with a lower risk of recurrent wheezing in children with rhinovirus infection (hazard ratio, 0.19) but not in those with respiratory syncytial virus (HR, 2.12) or those without either infection (HR, 2.03). They also found that prednisolone was associated with a lower risk of recurrent wheezing in children with eczema (HR, 0.15) but not in those without eczema (HR, 1.89).

"Considering the degree of morbidity that occurs from viral respiratory infection-induced wheezing in infants and toddlers, the relative absence of sustained adverse effects from short courses of corticosteroids, and the lack of efficacy of inhaled corticosteroids for viral wheezing, there appears to be justification to error on the side of treating with systemic corticosteroids until more definitive prospective studies are performed," according to the author of an accompanying editorial.

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