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Systemic corticosteroids in infant bronchiolitis: A meta-analysis.

AbstractOBJECTIVE:
To determine whether corticosteroids are efficacious in treating bronchiolitis in hospitalized infants.
METHODS:
Online bibliographic databases (Medline, Embase, and Cochrane Clinical Trials Registry) were searched for: 1) bronchiolitis or respiratory syncytial virus, and 2) corticosteroid or glucocorticoid or steroidal antiinflammatory agents or adrenal cortex hormones. Reference lists from all selected articles were also examined. Randomized, placebo-controlled trials of systemic corticosteroids in treatment of infants hospitalized with bronchiolitis were selected by 2 investigators. Of 12 relevant publications identified in the literature search, 6 met the selection criteria and had relevant data available. Investigators independently extracted data for 3 outcomes: length of stay (LOS), duration of symptoms (DOS), and clinical scores.
RESULTS:
In the pooled analysis, infants who received corticosteroids had a mean LOS or DOS that was.43 days less than those who received the placebo treatment (95% confidence interval: -.81 to -.05 days). The effect size for mean clinical score was -1.60 (95% confidence interval: -1.92 to -1.28), favoring treatment. Secondary analyses of mean LOS or DOS were performed on 5 trials that had clearly identified methods of randomization, 5 trials that measured LOS, and 4 trials that clearly excluded infants with previous wheezing. The estimates of effect were similar to the primary analysis but were not statistically significant.
CONCLUSIONS:
Combined, published reports of the effect of systemic corticosteroids on the course of bronchiolitis suggest a statistically significant improvement in clinical symptoms, LOS, and DOS.
AuthorsM M Garrison, D A Christakis, E Harvey, P Cummings, R L Davis
JournalPediatrics (Pediatrics) Vol. 105 Issue 4 Pg. E44 (Apr 2000) ISSN: 1098-4275 [Electronic] United States
PMID10742365 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Steroids
Topics
  • Anti-Inflammatory Agents (therapeutic use)
  • Bronchiolitis (drug therapy)
  • Data Interpretation, Statistical
  • Glucocorticoids (therapeutic use)
  • Humans
  • Infant
  • Length of Stay
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Steroids

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