Bronchiolitis, Viral Clinical Trial
Official title:
The Effectiveness of Oral Dexamethasone for Acute Bronchiolitis: A Multicenter Randomized Controlled Trial
This study will compare a single dose of oral dexamethasone to placebo in a multicenter, randomized, double blind trial of infants aged 2 to 12 months with first-time bronchiolitis (defined as wheezing within 7 days of onset). This is given as additional therapy beyond any other routine therapy used at that center. No current standard therapy is withheld, and no additional tests or other treatments are part of the study.The primary hypothesis is that dexamethasone will be more effective than placebo in preventing hospital admission. The secondary hypotheses are that dexamethasone will decrease respiratory scores and possibly the duration of the disease when compared to placebo, and that dexamethasone will be as safe and as well tolerated as placebo.
Bronchiolitis is the most common lower respiratory infection in infants, and the respiratory
condition leading to the most hospital admissions in young children. It is also probably the
most common serious illness of childhood lacking evidence-based treatment. Evidence both for
and against the effectiveness of corticosteroids such as dexamethasone has been published.
Editorials, expert reviews, and a recent report from the Agency for Healthcare Research and
Quality recommend a study such as this one.
Patients will be drawn from the emergency departments at participating medical centers in
the Pediatric Emergency Care Applied Research Network, created by the Emergency Medical
Services for Children program and the Maternal and Child Health Bureau of the Health
Resources and Services Administration to study health problems of high acuity and high
incidence in children.
Comparisons: The primary outcome (hospital admission after 4 hours of ED observation) and
secondary outcomes will be compared between treatment and placebo groups.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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