New approach needed for treating wheeze
03 November 2003

Some young children who wheeze after having a cold or virus may not be receiving the most effective treatment, say doctors. National Asthma Campaign experts have said more research is needed into treating this very specific group.

It is difficult to diagnose asthma in preschool children, as many infants of this age wheeze, and this does not necessarily mean they will continue to have asthma symptoms later in life. Wheezing in children aged 1–5 years can occur particularly after having a cold or flu-type virus, and is known to doctors as 'viral wheeze'.

Currently, parents of under-sixes may be given steroid tablets to administer to their children at the first signs of viral wheeze, depending on the child's previous pattern of illness.

Steroid tablets play a vital role in the treatment of asthma, and are beneficial in controlling symptoms in adults and in children who have gone on to deveop asthma.

However, researchers at the University of Leicester have found that for preschool children with viral wheeze, parental administration of oral steroids provided no clear benefits.

Dr Jonathan Grigg and colleagues studied a group of 200 children with a history of viral wheeze. Parents of half of the group were given steroid tablets called prednisolone to give to their children at the onset of wheeze, while the other half received a placebo, or dummy pill.

The researchers found no difference in symptoms between the two groups and, in their report, said that prescribing steroids to preschool children with viral wheeze, provided 'no clear benefits to balance potential risks.'

However, Professor Martyn Partridge, the Campaign's chief medical adviser, warned that further research was needed in this area: 'There are several other studies showing that in children in general, but not necessarily specifically in this group, a very short course of oral steroids does help. I think that most doctors will therefore use their clinical judgment in each individual case.'

Anne Pearson, a specialist nurse on the Campaign's Asthma UK Adviceline, advised: 'If you have been given steroid tablets for your child's wheezing, and you have concerns, you should go back to your GP for specific advice on your child's medication.'

The study was published in The Lancet.