Prednisolone in Preschool wheeze

Wheeze in preschool children is the most common cause of admission to hospital in the age group. In older children and adults, oral corticosteroids are proven to be an effective treatment for wheeze (asthma). However a similar treatment effect has not been demonstrated in the preschool population and effective treatment for preschool wheeze has proved to be difficult to find. There have only been a handful of studies on the clinical effects of corticosteroids (usually prednisolone) in preschool children with wheeze. These have typically been small studies, had some study design problems and have produced conflicting results – some suggesting they work, some suggesting they don’t. So currently no-one knows whether to continue to give preschool children with wheeze steroids. Administrationof steroids preschool wheeze use is included in clinical guidelines in New Zealand and internationally. However current practice varies greatly and often depends on personal presence. None of the previous trials have measured salbutamol response or used this to guide treatment, although this is currently used by clinicians to help guide treatment. Salbutamol response is an indicator of airway responsiveness and we hypothesise that a positive response is likely to increase the chance of steroids being effective. We aim to determine the clinical effect of oral corticosteroids in salbutamol responsive preschool wheeze