Allergy Asthma Respir Dis.  2017 Nov;5(6):326-330. 10.4168/aard.2017.5.6.326.

Systemic steroid treatment of acute bronchiolitis: A retrospective study

• Suh HR
• Ahn JY
• Choi BS

• KMID: 2396673
• DOI: http://doi.org/10.4168/aard.2017.5.6.326

Abstract

PURPOSE
Previous studies have reported that clinical efficacy of steroid therapy for acute bronchiolitis is controversial. However, since it is still frequently used in clinical practice, we sought to re-evaluate its effectiveness.
METHODS
This study included 277 children with acute bronchiolitis who were admitted to Kyungpook National University Children's Hospital from March 2013 to July 2016. Erythrocyte sedimentation rates, C-reactive protein (CRP) levels, and viral polymerase chain reaction testing results were obtained, and respiratory rate (RR) was measured periodically. Forty-eight patients were treated with an intravenous (IV) steroid (17.3%, IV group) and 19 patients were treated with a per oral (PO) steroid medication (6.9%, PO group). The remaining 210 patients were steroid-free patients (74.2%, nonsteroid group).
RESULTS
RR and CRP levels were higher in the IV group, along with a longer hospitalization period and duration of wheezing. The rate of change from the fastest initial RR to the mean RR on the first treatment day was greatest in the IV group; this finding was statistically significant after controlling for initial RR (16.06% in the IV group, 3.94% in the PO group, 4.90% in the nonsteroid group; P < 0.01).
CONCLUSION
There was a trend of IV steroid treatment toward more severe bronchiolitis. A significant reduction in RR on the first day of steroid treatment was observed in IV steroid-treated patients. IV steroid therapy may play a positive role in initial RR stabilization for severe bronchiolitis.

Keyword

Bronchiolitis; Steroid; Child

MeSH Terms

Blood Sedimentation
Bronchiolitis*
C-Reactive Protein
Child
Gyeongsangbuk-do
Hospitalization
Humans
Polymerase Chain Reaction
Respiratory Rate
Respiratory Sounds
Retrospective Studies*
Treatment Outcome
C-Reactive Protein

Figure

• 

  Fig. 1 (A) The mean value of initial CRP in the IV steroid group was higher than PO steroid group. (B) The mean duration of admission in the group of IV steroid was longer than other 2 groups. (C) The mean time of wheezing resolution after admission in IV steroid group was longer than other 2 groups. (D) The mean of initial respiratory rate in the first day of therapy in IV steroid group was faster than other 2 groups. CRP, C-reactive protein; IV, intravenous; PO, per oral.

• 

  Fig. 2 The result of multiplex real-time polymerase chain reaction (RT-PCR) detection test (n=103) shows respiratory syncytial virus (RSV) is the most common in any group. IV, intravenous; PO, per oral.

• 

  Fig. 3 The rate of change of respiratory rate (RR) between the fastest RR before treatment and the mean RR of first day of treatment was higher in intravenous (IV) steroid group than other 2 groups. PO, per oral.

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