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Oral Prednisolone for Acute Rhinovirus Induced Wheezing in Children Less Than 2 Years of Age

Phase 4
Recruiting
Conditions
Bronchiolitis Acute Viral
Interventions
Registration Number
NCT05444699
Lead Sponsor
University of Oulu
Brief Summary

The aim of the trial is to evaluate whether the use of oral prednisolone directed by point-of-care testing is useful in acute wheezing caused by rhinovirus in children aged 6-24 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
210
Inclusion Criteria
  • Wheezing bronchitis diagnosed by a physician
  • Need for salbutamol treatment at the emergency department
  • Positive nasopharyngeal rhinovirus or picornavirus finding in point-of-care testing
Exclusion Criteria
  • Need for immediate resuscitation
  • Immediate transfer to ICU
  • Suspected pneumonia based on the auscultation finding
  • Suspected serious bacterial infection
  • Other respiratory virus finding in the absence of rhinovirus or picornavirus
  • Positive respiratory syncytial virus finding
  • Positive SARS-coronavirus-2 finding
  • Positive Mycoplasma pneumoniae finding
  • Positive Bordetella pertussis finding
  • Contact with a person with chickenpox within 14 days
  • Active chickenpox
  • Suspected foreign body of the respiratory tract
  • Immunosuppressive treatment
  • Systemic corticosteroid treatment within 14 days
  • Allergy to corticosteroids

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PrednisolonePrednisolone Sodium PhosphatePrednisolone Sodium Phosphate (25 mg/5 mL) oral suspension administered 1 mg/kg\* (up to 20 mg = 4 mL) once a day for 3 days. \*(0-5 kg: 5 mg; 5.01-7.5 kg: 7.5 mg; 7.51-10 kg: 10 mg; 10.01-12.5 kg: 12.5 mg; 12.51-15 kg: 15 mg; 15.01-17.5 kg: 17.5 mg; ≥ 17.51 kg: 20 mg)
PlaceboSugar syrupSugar syrup oral suspension containing saccharum 630-640 mg/g and aqua purificata 360-370 mg/g administered the same amount in milliliters as experimental product (up to 4 mL) once a day for 3 days.
Primary Outcome Measures
NameTimeMethod
Length of hospital stayWithin 7 days of study entry

The difference (in minutes) between the study entry and the time that the patient is deemed to be fit for discharge (sign off for discharge)

Subgroup analyses for the primary outcome are performed in following subgroups:

* Children presenting with first episode of wheezing

* Children with at least one previous episode of wheezing diagnosed by a physician

* Children with a cycle threshold number of \< 30 for detected picornavirus

* Children with a cycle threshold number of 30-37 for detected picornavirus

* Children with a cycle threshold number of 38-40 for detected picornavirus

Secondary Outcome Measures
NameTimeMethod
Proportion of patients with cough at 14 days of study entryAt 14 days of study entry

Proportion of patients with cough at 14 days of study entry

Intensive care unit (ICU) admissionsWithin 7 days of study entry

Proportion of children admitted to ICU

Supplemental oxygenWithin 7 days of study entry

The total duration (in minutes) of the need for supplemental oxygen

Duration of respiratory distressWithin 14 days of study entry

Mean duration (in days) of respiratory distress without relapse for 3 days

Recurrence of wheezing (time)Within 12 months of study entry

Time (in days) to recurrence of wheezing diagnosed by a physician

Total length of hospital stayWithin 7 days of study entry

The difference (in minutes) between the study entry and the actual time of discharge from the hospital

Pediatric Early Warning Signs (PEWS) scoreWithin 7 days of study entry

Maximum decrease in PEWS score within 12 hours after study entry. PEWS scores range from 0 to 32 depending on the child's respiratory rate, work of breathing, saturation of peripheral oxygen, need for supplemental oxygen, blood pressure, heart rate, capillary refill and level of consciousness. 0 refers to low and \> 7 to high risk of deterioration.

Hospital re-admissionWithin 14 days of study entry

Proportion of patients with re-admission to hospital or visit to emergency department after discharge from the hospital

DeathsWithin 30 of study entry

Proportion of patients who died of any cause

Recurrence of wheezing (proportion)Within 12 months of study entry

Proportion of patients with recurrence of wheezing diagnosed by a physician at 2 and 12 months of study entry

Daily administrated asthma medicationWithin 24 months of study entry

Time (in days) to prescription of daily administrated asthma medication

Recurrence of wheezingWithin 56 days of study entry

Proportion of patients with recurrence of wheezing after initial episode

Duration of coughWithin 14 days of study entry

Mean duration (in days) of cough without relapse for 3 days

Duration of salbutamol useWithin 14 days of study entry

Mean number of days in which salbutamol is used

Antibiotics and asthma medicationsWithin 24 months of study entry

Purchases of antibiotics and asthma medications

Trial Locations

Locations (2)

SOITE Lastenpäivystys

🇫🇮

Kokkola, Finland

OYS Lastenpäivystys

🇫🇮

Oulu, Finland

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