THE EFFICACY OF STEROIDS IN THE TREATMENT OF BRONCHIOLITIS

Abstract

Objective: To determine the efficacy of steroids in the treatment of bronchiolitis.
Study Design: Randomised Controlled Trial (RCT)
Place and Duration of Study: 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
Patients and Methods: 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).
Results: 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).
Conclusions: 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.