Published 31 March 2009, doi:10.1136/bmj.b164
Cite this as: BMJ 2009;338:b164

Editorials

Inhaled corticosteroids after respiratory syncytial virus infection

Are ineffective and should not be used to prevent subsequent wheeze

The first 150 words of the full text of this article appear below.

Respiratory syncytial virus (RSV) infection often causes bronchiolitis in infants, and the season for infection started early this year, perhaps because it has been a cold winter (www.hpa.org.uk). Between 2% and 3% of infants are admitted to hospital with RSV each year. Supportive treatment with fluids, oxygen, and ventilation is still the only management option available because adrenaline, bronchodilators, steroids, ribavirin, and azithromycin offer no benefit or may even be harmful in the acute phase.1 2 3 RSV bronchiolitis can lead to secondary wheeze, and treatment options are also limited in this phase of the disease. In the linked randomised controlled trial (doi:10.1136/bmj.b897), Ermers and colleagues assess whether giving high dose hydrofluoroalkane extrafine beclometasone for three months after hospital admission for lower respiratory tract infection with RSV prevents recurrent wheeze.4

Reactive airways disease can occur after bronchiolitis, with a higher prevalence of recurrent wheeze in the shorter term . . . [Full text of this article]

Jenny Handforth, consultant paediatrician1, Jon S Friedland, professor2, Mike Sharland, consultant paediatrician3

1 Mayday University Hospital, Croydon CR7 7YE, 2 Department of Infectious Diseases and Immunity, Imperial College London, Hammersmith Campus, London W12 0NN, 3 Paediatric Infectious Diseases Unit, St George’s Hospital, London SW17 0QT

Jennifer.handforth@mayday.nhs.uk


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Relevant Article

The effect of high dose inhaled corticosteroids on wheeze in infants after respiratory syncytial virus infection: randomised double blind placebo controlled trial
Marieke J J Ermers, Maroeska M Rovers, Job B van Woensel, Jan L L Kimpen, Louis J Bont on behalf of the RSV Corticosteroid Study Group
BMJ 2009 338: b897. [Abstract] [Full Text] [PDF]

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