Abstract:Objective To investigate the efficacy of fluticasone propionate aerosol (flixotide) versus budesonide suspension in the treatment of recurrent wheezing caused by bronchiolitis. Methods A total of 214 infants with newly diagnosed bronchiolitis were randomly divided into flixotide treatment (106 infants) and budesonide treatment groups (108 infants), and were given aerosol inhalation of flixotide or budesonide for 3 months after achieving remission of clinical symptoms. Another 136 infants with bronchiolitis who did not receive regular inhalation of corticosteroid after achieving remission of clinical symptoms were enrolled as the control group. The follow-up visits were performed for 1 year, and the effects of the two therapeutic methods on recurrent wheezing were evaluated. Results Compared with the control group, both the flixotide and budesonide treatment groups had significantly fewer times of wheezing episodes within 1 year and a significantly lower recurrence rate of wheezing within the first 3 months after regular inhalation of corticosteroid, but no significant differences were observed between the two treatment groups. The amount of corticosteroid inhaled and hospital costs in the budesonide treatment group were significantly higher than in the flixotide treatment group (P<0.01). Conclusions Continuous inhalation of flixotide or budesonide after remission of clinical symptoms in children with bronchiolitis can reduce wheezing episodes and the recurrence of wheezing, and flixotide treatment is superior to budesonide treatment in the aspects of hospital costs and the amount of corticosteroid used.
LAN Wei-Ping,WANG Jing,DAI Chuan-Lin et al. Efficacy of fluticasone propionate aerosol versus budesonide suspension in treatment of recurrent wheezing caused by bronchiolitis[J]. CJCP, 2016, 18(4): 316-319.
Florin TA, Byczkowski T, Ruddy RM, et al. Variation in the management of infants hospitalized for bronchiolitis persists after the 2006 American Academy of Pediatrics bronchiolitis guidelines[J]. J Pediatr, 2014, 165(4): 786-792.
[2]
Rolfsjord LB, Skjerven HO, Bakkeheim E, et al. Children hospitalised with bronchiolitis in the first year of life have a lower quality of life nine months later[J]. Acta Paediatr, 2015, 104(1): 53-58.
[3]
Midulla F, Nicolai A, Ferrara M, et al. Recurrent wheezing 36 months after bronchiolitis is associated with rhinovirus infections and blood eosinophilia[J]. Acta Paeditr, 2014, 103(10): 1094-1099.
Wang EE, Milner RA, Navas L, et al. Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections[J]. Am Rev Respir Dis, 1992, 145(1): 106-109.
[7]
Global initiative for asthma. Global strategy for asthma management and prevention (2014 revision)[EB/OL].[2015-11-23].
[8]
Teeratakulpisarn J, Pientong C, Ekalaksananan T, et al. Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies[J]. Asian Pac J Allergy Immunol, 2014, 32(3): 226-234.
[9]
Proud D. Role of rhinovirus infections in asthma[J]. Asian Pac J Allergy Immunol, 2011, 29(3): 201-208.
[10]
Tantilipikorn P, Auewarakul P. Airway allergy and viral infection[J]. Asian Pac J Allergy Immunol, 2011, 29(2): 113-119.
[11]
Turunen R, Koistinen A, Vuorinen T, et al. The first wheezing episode: respiratory virus etiology, atopic characteristics and illness severity.Pediatr Allergy Immunol, 2014, 25(8): 796-803.
[12]
Piippo-Savolainen E, Korppi M. Wheezy babies-wheezy adults? review on long-term outcome until adulthood after early childhood wheezing[J]. ActaPaediatr, 2008, 97(1): 5-11.
[13]
Backman K, Piippo-Savolainen E, Ollikainen H, et al. Irreversible airway obstruction in adulthood after bronchiolitis in infancy: Evidence from a 30-year follow-up study[J]. Respir Med, 2014, 108(1): 218-223.