M S C WEBB, R L HENRY, AND A D MILNER
Department of Child Health, Queen’s Medical Centre, Nottingham

Reccurent wheezing attacks in children aged under 18 months are considerable source of morbidity and a not uncommon cause for admission to hospital, most of these children are suffering from asthma. Its mechanism are by no means fully understood, but suggestions has been that the pathology is primarily inflamation with mucosal oedema, inflamatory exudate, none of which would be susceptible to spesific bronchodilators. On the role of corticosteroids in the age group 0-18 months, it prompted to asses what part corticosteroid might have to play in the management of this difficult clinical problems.

Patients were randomly allocated to treatment with either placebo or soluble prednisolone 1.0 mg/kg twice daily for five days on a double blind basis. Statistical analysis employed the X-square test, Fisher’s exact test, and Mann-Whitney U test where appropriate. Statistical validity of the results was estimated using the sample size and power estimations Fleiss.

As discussion, it have been unable to show consistent benefit from treatment with corticosteroids over and above treatment with placebo for moderately severe asthma attacks in children aged under 18 months. Altough it is almost universal practice to administer corticosteroids to patients with either chronic persistent or acute asthma, there is still little documented proof of efficacy. Many studies concluded the effects of placebo, salbutamol alone, and dexamethasone alone were essentially the same, but that salbutamol and dexamethasone together were additive and significantly better than either alone.

It would agree with the finding suggesting that corticosteroids alone do not confer great advantage in the treatment of this age group as a whole, altough categorically the treatment with prednisolon did not improve some individuals. As conclusion, it have been unable to show definite clinical response attributable to treatment with oral prednisolone in moderately severe asthma in children aged under 18 months, and also can not extrapolate the data to comment on what effect corticosteroids might have in the treatmentof acute severe life threatening asthma in this age group.

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