(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Bronchiolitis

Topics: Administration, Inhalation; Beclomethasone; Bronchiolitis; Child, Preschool; Drug Evaluation; Humans; Infant; Nebulizers and Vaporizers; Recurrence; Respiratory Sounds

Previously, we showed that high-dose early initiated inhaled corticosteroids during respiratory syncytial virus bronchiolitis partially and transiently prevents subsequent recurrent wheeze. Here, we study treatment effect on lung function at age 6.. This is a 6-year follow-up report of a randomized placebo-controlled trial, in which 185 infants hospitalized for respiratory syncytial virus bronchiolitis were treated with early initiated, high-dose inhaled beclomethasone (n = 86) or placebo (n = 99) for 3 months. The primary outcome was forced expiratory volume in 1 second as percentage predicted. Secondary outcomes were bronchial hyperresponsiveness, physician-diagnosed asthma, hay fever and eczema. Possible toxicity was assessed by linear growth measurements.. At age 6, no significant differences were found in mean forced expiratory volume in 1 second percentage predicted between beclomethasone-treated and placebo-treated patients (91.4 vs. 93.4, mean difference 2.05 (95% confidence interval: -1.98 to 6.08). The proportion of bronchial hyperresponsiveness, physician-diagnosed asthma, parent reported hay fever and eczema was comparable between groups. There were no differences in linear growth.. Early initiated prolonged treatment with high-dose inhaled beclomethasone during hospitalization for respiratory syncytial virus infection during infancy did not improve the long-term respiratory outcome, but was safe.

Topics: Administration, Inhalation; Anti-Inflammatory Agents; Asthma; Beclomethasone; Bronchiolitis; Child; Child, Preschool; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Male; Respiratory Syncytial Virus Infections

To determine whether inhaled corticosteroid therapy given for 3 months after mild bronchiolitis decreases the incidence and/or severity of wheezing in the following 12 months.. Multicentric, single-blind, controlled, randomised intervention study.. Primary Health Care Centers in Lezo, Beraun, Andoain and Irún (Gipuzkoa, Spain).. Infants less than 12 months old (n = 94) diagnosed with mild bronchiolitis.. We established two groups of patients: group 1 (n = 47) was treated with inhaled beclomethasone (250 pg/12 hours) using a valved holding chamber (Babyhaler); the treatment started eight days after diagnosis of bronchiolitis and lasted 3 months. Group 2 (n = 47) received no treatment. We compared the number of wheezing episodes and their severity during the intervention period (3 months) and the follow-up period (12 months) with the Students t-test and the Chi-squared test.. We studied 89 infants (group 1, n = 42; group 2, n = 47), 67% of whom wheezed during the study period (15 months). There were no significant differences between the treatment and the control group in the study periods.. Inhaled beclomethasone given for 3 months does not significantly modify the occurrence of wheezing episodes during the treatment period or during the following 12 months.

Topics: Administration, Inhalation; Beclomethasone; Bronchiolitis; Female; Glucocorticoids; Humans; Infant; Male; Respiratory Sounds; Single-Blind Method

Forty four children with recurrent obstructive episodes after acute bronchiolitis in infancy were treated with nebulised beclomethasone dipropionate or placebo for eight weeks in a randomised double-blind study. They were seen monthly for a year afterwards, and also if they had acute respiratory illnesses with or without bronchopulmonary obstruction. The two treatment groups were well matched. The children receiving active treatment had significantly fewer symptomatic respiratory illnesses and fewer episodes of bronchopulmonary obstruction during the follow up period. The children given placebo had significantly higher obstructive scores during the study period, and they were treated with inhaled beta 2 agonists and theophylline for longer periods of time during the follow up period. The results suggest that nebulised beclomethasone dipropionate may have prolonged effects on subsequent asthmatic symptoms after termination of treatment in children with recurrent obstructive episodes after acute bronchiolitis.

Topics: Acute Disease; Administration, Inhalation; Beclomethasone; Bronchiolitis; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Follow-Up Studies; Humans; Infant; Lung Diseases, Obstructive; Nebulizers and Vaporizers; Random Allocation; Recurrence; Time Factors

Topics: Anti-Inflammatory Agents; Beclomethasone; Bronchiolitis; Female; Humans; Male; Respiratory Syncytial Virus Infections

Topics: Albuterol; Amoxicillin; Anti-Infective Agents; Anti-Inflammatory Agents; Asthma; Beclomethasone; Bronchiolitis; Bronchodilator Agents; Child, Preschool; Drug Therapy, Combination; Female; Humans; Infant; Male; Practice Guidelines as Topic; Respiratory Syncytial Virus Infections