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Combo Treatment Eases Wheezing in Babies
Date:5/13/2009

n days, 17.1 percent of babies in the double-treatment group had to be hospitalized. In comparison, 23.7 percent in the epinephrine-only group had to be admitted, 25.6 percent in the dexamethasone group were hospitalized, and 26.4 percent in the placebo group were admitted to the hospital.

The group that received the combination treatment also needed less medical care, stopped wheezing sooner, and returned to normal feeding sooner than babies in the other groups.

"I think we now have good evidence of a combined treatment that appears to have benefits in reducing hospitalizations and proving treatment benefits," said Plint.

Not everyone agrees, however.

The editorial authors wrote that, "Given the small effect size of the study -- 11 infants would have to be treated to prevent one hospital admission -- it does not seem practical to apply the treatment, especially considering the potential effects of high-dose corticosteroids on brain and lung development in such young children."

However, Plint said the treatment was well-tolerated, and there's no evidence in this age group that there are any neurodevelopmental effects from a short course of steroids. And, she pointed out, steroids are often given to help the lungs mature in premature infants.

"Parents should understand when looking at different treatment modalities, a combination of medications may be more effective than either one alone. But, more studies need to be done," said Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital in Detroit.

Appleyard said she is concerned, however, that if this combination becomes the treatment of choice in the emergency room that children who make multiple visits over the course of a viral season might end up getting repeated high doses of steroids.

Plint said that this combination treatment should only be used for a child's first episode of wheezing.

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