The functional response of infants with persistent wheezing to nebulized beclomethasone dipropionate

Lung function was measured in nine infants, ages 15‐36 weeks, who had persistent wheezing, apparently following acute bronchiolitis, before and after 2 weeks of treatment with either inhaled nebulized beclomethasone dipropionate (BDP) or placebo in a randomized, double blind, crossover trial. The effect of nebulized albuterol (Salbutamol) was measured before and after the steroid treatment. Thoracic gas volume (TGV) and specific airway conductance (SG_aw) were determined using a whole body plethysmograph, and forced expiratory flow at resting lung volume (V_maxFRC) was determined with a thoracoabdominal compression jacket. All infants had marked airways obstruction before treatment with mean ± SE V_maxFRC of 24 ± 4% predicted and SG_aw of 37 ± 5% predicted. Two weeks of placebo treatment had no significant effect on lung function, but after 2 weeks of BDP inhalation there was a significant rise in SG_aw to 61 ± 7% (P < 0.005). V_maxFRC increased to 42 ± 13% but the difference did not reach significance. Respiratory rate and clinical score for retractions and wheezing also fell significantly with BDP therapy (P < 0.01 and P < 0.001 respectively). Albuterol had no effect on lung function either before or during steroid therapy. Steroids may have a role in the management of persistent wheezing following bronchiolitis.