INTERMITTENT TREATMENT WITH INHALED STEROIDS FOR DETERIORATION OF ASTHMA DUE TO UPPER RESPIRATORY-TRACT INFECTIONS

Upper respiratory tract infection (URTI) is a common cause of deterior ation of asthma in children. We investigated if inhaled steroids (bude sonide), started early after URTI, could reduce asthma. Thirty-one chi ldren, 3-10 years of age, with deterioration during URTI participated. The study design was double-blind, crossover and placebo-controlled. Peak-expiratory flow (PEF) and symptom scores were recorded. Four trea tment periods of 9 days, two with budesonide and two with placebo, wer e planned. Treatment was started at the first sign of URTI. Budesonide /placebo was given by Turbuhaler at 0.2 mg qid for 3 days, tid for 3 a nd bid for the last 3 days. Twenty-two children completed 67 periods. Eleven visited the emergency room, only three during budesonide therap y. Five received oral steroids and two where admitted to hospital, all receiving placebo. Symptom scores were not significantly lower during budesonide treatment. PEF, both morning and evening, was significantl y higher during budesonide than placebo (p = 0.015 and p = 0.022). Inh aled budesonide can attenuate exacerbation of URTI-induced asthma.