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Steroid Treatment for Wheezing Questioned

Episodic attacks of wheeze triggered by viral cold are common in preschoolers. These attacks are different from allergic asthma since the frequency disappears by school age. //The current recommendation is that parents administer oral steroids at the first sign of an attack. But whether or not the steroids are effective is controversial.

The research shows a course of steroids was no more effective than placebo in reducing respiratory symptoms or the need for hospital admission.

Researchers in England compared the outcomes of children on steroids to those on a placebo. More than 200 children with a history of wheezing were part of the study. The children were randomly assigned to a five-day course of oral prednisolone or placebo to be given at the start of a wheeze attack. Parents then recorded their children's respiratory symptoms and noted if their child was taken to the hospital.

Researchers found no difference in daytime or nighttime respiratory symptoms between children who received the steroid and those who received the placebo. They also found no difference in the symptoms or rate of hospital admission between children with high or low levels of wheezing. Surprisingly, study authors say more children on the steroid ended up in the hospital than those on the placebo, though the numbers were not statistically significant.

Study authors conclude the findings of this study suggest the use of oral steroids may need to be re-evaluated for preschool children with a viral wheeze.

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