Steroid helpful in early wheezing due to colds

By Megan Rauscher

NEW YORK (Reuters Health) - Oral treatment with the steroid prednisolone reduces relapses in young children with a first or second bout of wheezing associated with the common cold (rhinovirus), a study shows.

Prednisolone does not appear to be effective for early wheezing associated with another type of respiratory virus called respiratory syncytial virus (RSV), according to the study.

"Our results agree with previous studies showing that corticosteroids do not offer short- or long-term benefits in patients with RSV infection," note Dr. Tuomas Jartti from Turku University Hospital, Finland and colleagues in a report in The Pediatric Infectious Disease Journal.

The Finnish team compared prednisolone (2 mg/kg per day in three divided doses for 3 days) with placebo in 78 preschool-age children who were hospitalized with a first or second episode of wheezing induced by rhinovirus or RSV. Children with mixed viral infections were excluded from the study.

Prednisolone treatment significantly decrease relapses during the subsequent two months in rhinovirus-infected children and in children with high levels of eosinophils -- a type of blood cell known to play a role in inflammation.

"Prednisolone decreased blood eosinophils, which was closely related to the rhinovirus infection," the team reports. Compared with RSV-infected children, rhinovirus-infected children were more likely to have atopy (allergy) and had significantly more blood eosinophils on admission.

In comments to Reuters Health, Jartti said: "We believe that our study supports the view that systemic corticosteroids in the dosages used are beneficial in the treatment of first or second time wheezing associated with rhinovirus infection and/or (elevated) blood eosinophils."

"Recently," Jartti also mentioned, "rhinovirus-induced early wheezing has been suggested as a new major risk factor for recurrent wheezing, and it has even been related to school age asthma."

SOURCE: The Pediatric Infectious Disease Journal June 2006.