Abstract | RATIONALE: METHODS: In this randomized double blind trial, previously healthy outpatients 2-23 months of age with bronchiolitis and Respiratory Disease Assessment Instrument (RDAI) score 6 or more received 1 mg/kg of oral dexamethasone in the Emergency Department. Prior to discharge at 4 hr they were randomized to either 4 daily doses of dexamethasone 0.15 mg/kg or placebo equivalent. Primary outcome was the proportion of subsequent hospitalizations or prescribed trials of bronchodilator/ corticosteroid therapy for dyspnea by day 6 in the groups. Secondary outcomes were changes in the RDAI to day 6, and proportions with unscheduled visits by days 6 and 28. RESULTS: The rate of primary outcome in the single dose group (SDG, N = 64) was 9/64 or 14.1% versus 7/61 or 11.5% in the multiple dose group (MDG, N = 61) [95% CI 0.09; 0.14]. Twelve (18.8%) children in the SDG had unscheduled medical visits by day 6 versus 11 (18.0%) children in the MDG [95% CI 0.13; 0.14]. On day 6 the RDAI decreased from 9.5 +/- 2.1 to 2.1 +/- 2.4 in the SDG and from 9.8 +/- 2.2 to 1.6 +/- 2.3 in the MDG [95% CI 0.36; 2.06]. Between days 7-28, 24/64 (37.5%) SDG infants returned for care versus 20/61 (32.8%) of the MDG [95% CI 0.12; 0.21]. CONCLUSIONS: Our study suggests that, in outpatients with bronchiolitis who receive dexamethasone, continuation of this agent beyond the initial dose does not provide significant benefit.
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Authors | Suzanne Schuh, Allan L Coates, Paul Dick, Derek Stephens, Amina Lalani, Erika Nicota, Matthew Mokanski, Svetlana Khaikin, Upton Allen |
Journal | Pediatric pulmonology
(Pediatr Pulmonol)
Vol. 43
Issue 9
Pg. 844-50
(Sep 2008)
ISSN: 1099-0496 [Electronic] United States |
PMID | 18668692
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | (c) 2008 Wiley-Liss, Inc. |
Chemical References |
- Glucocorticoids
- Dexamethasone
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Topics |
- Bronchiolitis
(drug therapy)
- Dexamethasone
(administration & dosage)
- Double-Blind Method
- Female
- Glucocorticoids
(administration & dosage)
- Humans
- Infant
- Male
- Respiratory Sounds
(drug effects)
- Time Factors
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