THE ROLE OF CORTICOSTEROIDS IN THE TREATMENT OF ACUTE BRONCHIOLITIS IN INFANTS

The management of acute bronchiolitis in infants is difficult because of the different physiopathologic mechanisms involved in the initial episode and recurrent attacks and the problems encountered in the maturation of the bronchopulmonary apparatus. The use of corticosteroids in the treatment of this disease in infants is still a subject of debate. Most clinical studies of the administration of corticoids by systemic route concluded that they had little effect in the short term on the clinical course of the respiratory illness. However these trials were made some time ago, a variety of drugs were used, and there were no functional respiratory studies or long term follow up. It may now be the time to reconsider the indications for corticoid treatment by systemic route in the management of episodes of acute bronchiolitis with respiratory syncitial virus (RSV). There is no evidence that inhalation of corticoids is effective in initial acute viral episodes. In contrast, several studies have shown that during convalescence this treatment significantly reduces the duration of the clinical course, drug dosage and the short-term sequelae associated with bronchial hyperreactivity.