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Prednisolone Reduces Wheezing in Children with Colds

July 12, 2006

For children with wheezing associated with the common cold, prednisolone taken orally may reduce the risk of relapse, according to a new study.

However, prednisolone appears ineffective in alleviating wheezing associated with respiratory syncytial virus (RSV), another virus.

The study, by Tuomas Jartti and colleagues from Turku University Hospital, Finland, was published in the June issue of The Pediatric Infectious Disease Journal and reported by Reuters on July 4.

"Our results agree with previous studies showing that corticosteroids do not offer short- or long-term benefits in patients with RSV infection," wrote the authors.

Clinical Trial

The study included 78 preschool-age children hospitalized with a first or second episode of wheezing associated with rhinovirus (the virus that causes the common cold), or with RSV. The researchers compared the effectiveness of prednisolone (a total of 2 mg/kg per day, in three doses, over 3 days) with placebo.

Children who had both rhinovirus and RSV infections were excluded from the study.

The children with rhinovirus who received prednisolone experienced significantly fewer relapses during the following two months, as did children with high levels of eosinophils (a type of white blood cell involved in inflammation).

"Prednisolone decreased blood eosinophils, which was closely related to the rhinovirus infection," the authors reported.

Compared with children who had RSV infection, children with rhinovirus were more likely to have atopy (allergy) and had significantly higher levels of blood eosinophils on admission.

"We believe that our study supports the view that systemic corticosteroids in the dosages used are beneficial in the treatment of first or second time wheezing associated with rhinovirus infection and/or (elevated) blood eosinophils," said Dr Jartti in an interview with Reuters Health.

He added, "Recently, rhinovirus-induced early wheezing has been suggested as a new major risk factor for recurrent wheezing, and it has even been related to school age asthma."

Evaluation of the Efficacy of Prednisolone in Early Wheezing Induced by Rhinovirus or Respiratory Syncytial Virus. Tuomas Jartti, et al, The Pediatric Infectious Disease Journal, volume 25(6), pages 482-488, June 2006.
Steroid helpful in early wheezing due to colds, Reuters, July 4, 2006.

Posted: July 2006