FRIDAY, Oct. 31, 2003 (HealthDayNews) -- Giving a preschooler an oral steroid to treat a serious wheezing problem does no good and might cause some harm, a new British study concludes.
Wheezing episodes triggered by cold viruses are common in children aged 1 to 5, says Dr. Jonathan Grigg, a senior lecturer in pediatric thoracic medicine at the University of Leicester. However, only a few of these children go on to develop asthma, he adds. For most, the problem disappears by the time they reach grade school.
It is fairly common practice to have parents administer an oral steroid such as prednisolone when a wheezing episode occurs, Grigg says, but its effectiveness has rarely been tested.
In his study, reported in the Nov. 1 issue of The Lancet, 51 children brought to the Leicester Children's Asthma Centre with a serious wheeze were given oral prednisolone, while another 69 got a placebo.
The level of respiratory symptoms and the need for hospitalization was virtually the same in both groups, Grigg says, although there was a slight trend toward more hospital admissions for the children given the steroid.
"We were surprised to see that," Grigg says. "Normally, we don't think steroids do any harm. The finding was either incidental or, as we suspect, may change a child's behavior and impact on the decision to hospitalize."
Non-asthmatic wheezing episodes are common in young children, he says. "In our population, up to 40 percent have a wheezing episode," he says. "The majority do not go on to develop allergic asthma."
The study does not rule out the use of steroids in all cases, Grigg says: "The physician has to use judgment. If it is a severe episode, the potential risks are outweighed by the possible benefits."
The British finding reinforces what is common practice in the United States, says Dr. Pramod Kelkar, an allergist who is a spokesman for the American College of Allergy, Asthma and Immunology.
Physicians usually treat wheezing episodes with an airway-widening bronchodilator drug such as albuterol, given four times daily for four to seven days, Kelkar says. An inhaled steroid may be prescribed as well as the bronchodilator in some cases, he says, rather than an oral steroid such as prednisolone or its close relative prednisone.
The British study should tell parents "that giving prednisone without a clinical evaluation by a physician will not be of much benefit," Kelkar says.
More information
The basics of respiratory conditions such as asthma can be found at the American Academy of Allergy, Asthma and Immunology. Here's more on asthma and kids.
