Single Dose Versus Multiple Doses of Dexamethasone in Children With Acute Bronchiolitis

Efficacy of Single Dose Versus Multiple Doses of Dexamethasone in Outpatients With Acute Bronchiolitis

This study is to determine the effectiveness of five-day treatment versus a single dose of oral dexamethasone (corticosteroid) in children between 2 and 24 months of age with a first episode of acute bronchiolitis presenting in the Emergency Department

Inclusion Criteria:

• infants 2 to 24 months of age
• acute bronchiolitis, defined as first episode of wheezing with upper respiratory infection and respiratory distress
• moderate to severe baseline disease severity (Respiratory Distress Index (RDAI) score 6 to 15)
• only patients discharged at or shortly after 240 minutes of uniform stabilization therapy will be randomized

Exclusion Criteria:

• previous wheezing and/or bronchodilator therapy
• hospitalization at 240 minutes
• critically ill patients needing airway stabilization
• patients with low or very high baseline disease severity (RDAI <5 and >16)
• patients under 8 weeks of age
• patients on corticosteroids prior to arrival at Emergency Department
• contact with varicella within 21 days
• past history of ventilation for greater than 24 hours
• existing cardiopulmonary disease, multisystem disease or immunodeficiency
• insufficient command of the English language