Steroid Medications Ineffective for Pediatric Respiratory Infections

A new study has found that steroid treatment did not prevent hospitalization or improve respiratory symptoms for bronchiolitis, a common and potentially serious viral lower respiratory infection and the most common cause of infant hospitalization.

Researchers of the of the Morgan Stanley Children's Hospital of New York-Presbyterian and Columbia University Medical Center (MSCHONY; NY, NY, USA) compared hospitalization rates for 600 children between the ages of two months and 12 months who visited emergency rooms with moderate-to-severe bronchiolitis. Patients were treated with either a dose of dexamethasone (a glucocorticoid form of steroid medication) or a placebo and evaluated after one hour, and again at four hours. The hospital admission rate for both groups was identical at nearly 40%.

The researchers reported that both groups improved during treatment, but the placebo group did as well as the group treated with active medication. The three-year study was conducted in the emergency departments at 20 hospitals across the United States.
The study was published in the July 26, 2007, edition of the New England Journal of Medicine (NEJM).

"Our study shows that treating bronchiolitis with steroids doesn't work. We hope this study will resolve some of the uncertainty for physicians and families, as we move forward in developing better means of preventing and treating the infection,” said lead author Dr. Joan Bregstein, from MSCHONY, and an assistant clinical professor of pediatrics at Columbia University College of Physicians and Surgeons (New York, NY, USA).

Bronchiolitis is an inflammation of the membranes lining the bronchioles. The majority of children hospitalized for bronchiolitis are under six months old, and most recover from it in eight to 15 days. Although many children with bronchiolitis have mild infections and most do not need hospitalization, children born prematurely or who suffer from heart and lung disease are most at risk for complications.


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Morgan Stanley Children's Hospital of New York