Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection-induced lower airway disease:: A randomized, placebo-controlled trial

Objective To investigate the efficacy of oral prednisolone in virally induced respiratory distress. Study design Randomized, double-blind, placebo-controlled trial involving 230 children age 6 to 35 months in the emergency department. Each patient received either oral prednisolone (2 mg/kg/d) or placebo for 3 days. Results The hospitalization rates were similar between the two groups. For admitted children (n = 123), the median length of stay was 1 day shorter in the prednisolone group (2 vs 3 days, P = .060). The proportion of children requiting greater than or equal to3 days of hospitalization was 47.5% in the prednisolone group and 67.7% in the placebo group (P = .023). There, was less need for additional asthma medication (18.0% vs 37.1%, P = .018) in the prednisolone group. The median duration of symptoms of respiratory distress was 1 day in the prednisolone group versus 2 days in the placebo group both among the hospitalized (P < .001) and nonhospitalized children (P = .006). Conclusion A 3-day course of oral prednisolone effectively reduced disease severity, length of hospital stay, and the duration of symptoms among children 6 to 35 months old with vitally induced respiratory distress.