Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection-induced lower airway disease: a randomized, placebo-controlled trial☆

Abstract 

Objective

To investigate the efficacy of oral prednisolone in virally induced respiratory distress.

Study design

Randomized, double-blind, placebo-controlled trial involving 230 children age 6 to 35 months in the emergency department. Each patient received either oral prednisolone (2 mg/kg/d) or placebo for 3 days.

Results

The hospitalization rates were similar between the two groups. For admitted children (n=123), the median length of stay was 1 day shorter in the prednisolone group (2 vs 3 days, P=.060). The proportion of children requiring ≥3 days of hospitalization was 47.5% in the prednisolone group and 67.7% in the placebo group (P=.023). There was less need for additional asthma medication (18.0% vs 37.1%, P=.018) in the prednisolone group. The median duration of symptoms of respiratory distress was 1 day in the prednisolone group versus 2 days in the placebo group both among the hospitalized (P<.001) and nonhospitalized children (P=.006).

Conclusion

A 3-day course of oral prednisolone effectively reduced disease severity, length of hospital stay, and the duration of symptoms among children 6 to 35 months old with virally induced respiratory distress.

Keywords:  DOS, Duration of symptoms, ED, Emergency department