The Effectiveness of Oral Dexamethasone for Acute Bronchiolitis: A Multicenter Randomized Controlled Trial
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 598
- 试验地点
- 1
- 主要终点
- Hospital admission after 4 hours of ED observation
研究概览
简要总结
This study will compare a single dose of oral dexamethasone to placebo in a multicenter, randomized, double blind trial of infants aged 2 to 12 months with first-time bronchiolitis (defined as wheezing within 7 days of onset). This is given as additional therapy beyond any other routine therapy used at that center. No current standard therapy is withheld, and no additional tests or other treatments are part of the study.The primary hypothesis is that dexamethasone will be more effective than placebo in preventing hospital admission. The secondary hypotheses are that dexamethasone will decrease respiratory scores and possibly the duration of the disease when compared to placebo, and that dexamethasone will be as safe and as well tolerated as placebo.
详细描述
Bronchiolitis is the most common lower respiratory infection in infants, and the respiratory condition leading to the most hospital admissions in young children. It is also probably the most common serious illness of childhood lacking evidence-based treatment. Evidence both for and against the effectiveness of corticosteroids such as dexamethasone has been published. Editorials, expert reviews, and a recent report from the Agency for Healthcare Research and Quality recommend a study such as this one.
Patients will be drawn from the emergency departments at participating medical centers in the Pediatric Emergency Care Applied Research Network, created by the Emergency Medical Services for Children program and the Maternal and Child Health Bureau of the Health Resources and Services Administration to study health problems of high acuity and high incidence in children.
Comparisons: The primary outcome (hospital admission after 4 hours of ED observation) and secondary outcomes will be compared between treatment and placebo groups.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 2 Months 至 11 Months（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •First attack of wheezing within 7 days of onset
- •Age 2 months through 11 months (less than 12 months)
- •Disease of at least moderate severity (RDAI score greater than or equal to 6)
排除标准
- •Prior adverse reaction to dexamethasone
- •Known heart or lung disease
- •Premature birth prior to 36 weeks' gestation
- •History of prior asthma or bronchodilator use
- •Immune suppression or deficiency
- •Trisomy 21
- •Critical or life-threatening complications of bronchiolitis
- •Treatment with corticosteroids within 14 days
- •Known active chickenpox
- •Exposure to chickenpox within 21 days
- •Child sent to ED for automatic admission
研究组 & 干预措施
Dexamethasone
1mg of Dexamethasone/kg
干预措施: dexamethasone (Drug)
Placebo
1mg/kg placebo
干预措施: Placebo (Drug)
结局指标
主要结局
Hospital admission after 4 hours of ED observation
时间窗: 4 hours
次要结局
- Severity of disease measured by respiratory (RDAI) scores, vital signs, and oximetry.(4 hours)
- Duration of hospitalization (if admitted) measured at 7-to-10 day followup.(7-10 days)
- Safety, toleration, and parental satisfaction measured at 7-to-10 day followup.(7-10 days)