Do oral corticosteroids reduce the severity of wheezing episodes in preschool children?

Published Online: March 15, 2013

Asthma guidelines recommend treatment with oral corticosteroids (OCS) for significant asthma exacerbations. Extensive data supports this recommendation for asthma exacerbations among school-aged children and adolescents. However, there is very little evidence to support OCS treatment in preschool aged children with recurrent wheezing episodes.

In a study recently published in The Journal of Allergy and Clinical Immunology, Beigelman et al, on behalf of the Childhood Asthma Research and Education (CARE) Network, investigated whether OCS reduce the severity of symptoms during acute lower respiratory tract illnesses (LRTI) among preschool children with recurrent wheeze.
The researchers investigated data from a total of 493 children aged one to five years with repeated episodes of wheezing who participated in two clinical trials of the CARE Network. The investigators compared the severity of symptoms during LRTIs between illnesses that were treated with OCS and those illnesses of similar severity that were not treated with OCS. OCS treatment did not reduce symptom severity during the episodes in either of studies examined.

The authors concluded that OCS treatment in preschool children with episodic wheezing did not reduce the severity of acute exacerbations. However, these results were obtained from analyzing studies done for purposes other than directly studying the effect of OCS on these illnesses. Therefore the researchers indicate that the apparent lack of benefit from OCS treatment in this setting need to be confirmed in studies designed specifically to answer this question before the asthma guidelines and clinical practice regarding treatment of acute wheezing episode in this age group should be changed.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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