Role of Dexamethasone in the Treatment of Acute Bronchiolitis

Background: Bronchiolitis is a lower respiratory tract infection that occurs in children younger than two years old. It is usually caused by viruses, Bronchiolitis is a common cause of illness and is the leading cause of hospitalization in infants and young children. Bronchiolitis diagnosed clinically and can be treated by adequate fluids and oxygen therapy

Aim of the study: to assess the efficacy of dexamethasone in the treatment of acute bronchiolitis.

Patients Methods: A case control study was done at the pediatrics department of the AL-Diwaniya maternity and children hospital on 100 children aged below 24 months, with a clinical diagnosis of acute bronchiolitis, who were admitted during the period from the 1st of October 2013 to the 31th of March 2014.The patients enrolled in the study were divided in two groups: group 1 (48 patients) that received dexamethasone and group 2 (52 patients) that did not receive dexamethasone. All hundred patients have the same baseline characteristics of admission and treatment except for that of dexamethasone then a comparison between the two groups was done.

Results: Most of the cases 22 (78.5%) in group 1 started to improve within the 1st to 2nd day of admission while in group 2 most of cases 24 (46.1) started to improve within the third and fourth day of admission. P-values were 0.79 (non-significant). In Group 1,the mean and standard deviation for heart rate were decreased by 20.2±1.1, respiratory rate decreased by 11±2.1 and the mean SpO2 Increased by 3.4±0.3. In Group 2 there was a similar change after 24 hours with mean heart rate decreased by 19±1, mean respiratory rate falling by 11.6±0.7, and mean SpO2 increasing by 2.5±0.3. On analysis, there was no significant changes in the HR, RR, SpO2 between the two groups. Most of the cases in both groups discharged within 3rd-6th days of admission 28 cases (58.3%) in group 1 and 29 cases (55.7%) in group 2, p values were 0.99 (non-significant).

Conclusion: the clinical trials of Dexamethasone show no significant beneficial effect in the treatment of bronchiolitis.