Arch Dis Child 2001;85:143-148 ( August )

Article

Persistent wheezing in infants with an atopic tendency responds to inhaled fluticasone R J Chavasse, Y Bastian-Lee, H Richter, T Hilliard, P Seddon

The Royal Alexandra Hospital for Sick Children, Dyke Road, Brighton BN1 3JN, UK

Correspondence to: Dr R J Chavasse, The Royal Brompton and Harefield NHS Trust, The Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK chavasse{at}madasafish.com

Accepted 15 March 2001

BACKGROUNDThe role of inhaled corticosteroids for the treatment of wheeze in infancy remains unclear.
AIMTo investigate the effect of inhaled fluticasone on symptoms in a group of wheezy infants who had a high risk of progressing to childhood asthma.
METHODSA total of 52 infants, under 1 year of age, with a history of wheeze or cough and a history (personal or first degree relative) of atopy were prescribed either 150 µg fluticasone twice daily (group F) or placebo (group P), via metered dose inhaler, for 12 weeks following a two week run in period. Symptoms were scored in a parent held diary and the mean daily symptom score (MDS) and symptom free days (SFD) calculated for each two week period.
RESULTSThirty seven infants completed the study. Both MDS and SFD improved significantly between the run in and final two week period in group F, but not group P, with a mean difference in change (95% CI) between groups of 1.12 (0.05 to 2.18) for MDS and median difference of 3.0 (0.002 to 8.0) for SFD.
CONCLUSIONImprovement of clinical symptoms in response to fluticasone can be shown in this high risk group of infants. In the absence of effective alternatives inhaled corticosteroids should be considered in this patient group.


Keywords: fluticasone; asthma; wheeze; corticosteroid; inhaled

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© 2001 by Archives of Disease in Childhood
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