- Meeting abstract
- Open Access
ORAL montelukast versus inhaled beclomethasone in the prophylactic treatment of post ACUTE viral bronchiolitis wheezing
World Allergy Organization Journal volume 8, pageA128 (2015)
Acute viral bronchiolitis is one of the most common respiratory infections in infancy, leading to the hospitalization of about 1-2% of infected infants. A number of studies have suggested that hospitalization due to bronchiolitis could increased the risk of developing pulmonary sequelae, specially recurrent cough and wheezing.
This is a randomized, pilot study, involving infants ≤ 1 year of age hospitalized due to acute viral bronchiolitis. All patients with moderate-severe bronchiolitis (Wang score ≥ 8) are eligible to initiate the study. At hospital discharge, recruited patients are randomized into three study groups - conventional treatment, oral montelukast (MK) or inhaled beclomethasone dipropionate (BDP) - and directed to monthly follow-up appointments for 6 months. We aim to determine the potential benefit of inhaled BDP and oral MK in the natural history of post bronchiolitis wheezing. The primary variables are: need of hospitalization and number of visits to the emergency department (ED). The secondary variables are: number of days until first exacerbation, duration of hospitalization, number of asymptomatic days and need of bronchodilator and/or oral corticosteroid.
Until this moment, 47 patients were randomized, out of which, 26 ended the study, being 9 in the no treatment group(A), 11 in the oral MK group (B) and 6 in the inhaled BDP group (C). Considering the primary variables, only one hospitalization was reported in the no treatment group A. Among group A, 3 visits to the ED were reported and 5 infants needed to use albuterol spray (1-3 times); 1 patient was excluded. Among the 11 patients in the oral MK group B, 2 infants developed a wheezing episode following a viral respiratory infection, 2 visits to the ED were reported and 4 infants needed to use albuterol spray (1-2 times); 2 patients were excluded. Among the 6 patients in the inhaled BDP group C, 2 infants needed to use albuterol spray (1-3 times); 2 patients were excluded.
To the extent of our knowledge, there are no studies comparing inhaled BDP and oral MK in the prophylaxis of post acute viral bronchiolitis wheezing. A larger number of patients will allow us to establish more significant statistical data. More studies are necessary to establish the presumable benefit of MK and/or inhaled BDP in the history of post bronchiolitis recurrent wheezing.