efficacy of steroids in the treatment of bronchiolitis

ABSTRACT

To determine the efficacy of steroids in the treatment of bronchiolitis. Study Design: Randomised Controlled Trial [RCT]. The Department of Paediatrics, Military Hospital, Rawalpindi and the Department of Paediatrics, PNS Shifa Hospital, Karachi for six months, from Feb 2006 to Aug 2006. Ninety patients of bronchiolitis were sampled and randomly divided into three groups. Each group was given the same treatment protocol differing only in the steroid given [Group I - intravenous Hydrocortisone, Group II - nebulised Beclomethasone, Group III - no steroids]. Data was compiled by means of a proforma. Outcomes were length of hospital stay [LOS], difference in clinical respiratory score [R], and time to become wheeze free [W]. Mean LOS was lowest in Group II [p = 0.259]. The mean duration to become wheeze free [W] was also lowest in Group II [p= 0.40]. The biggest improvement in Respiratory Distress Assessment Instrument [RDAI] score at admission and discharge [R] was in Group I and least improvement in Group II [p=0.056]. Corticosteroids are not significantly effective in reducing length of hospital stay, duration of wheezing and improvement in clinical severity. However, inhaled steroids may possibly have a potential advantage over parenteral steroids