Intended for healthcare professionals


Inhaled corticosteroids after respiratory syncytial virus infection

BMJ 2009; 338 doi: (Published 31 March 2009) Cite this as: BMJ 2009;338:b164
  1. Jenny Handforth, consultant paediatrician1,
  2. Jon S Friedland, professor2,
  3. Mike Sharland, consultant paediatrician3
  1. 1Mayday University Hospital, Croydon CR7 7YE
  2. 2Department of Infectious Diseases and Immunity, Imperial College London, Hammersmith Campus, London W12 0NN
  3. 3Paediatric Infectious Diseases Unit, St George’s Hospital, London SW17 0QT
  1. Jennifer.handforth{at}

    Are ineffective and should not be used to prevent subsequent wheeze

    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 ( 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 …

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