Prevention of Admission for Bronchiolitis

Bronchiolitis is a viral infection of the lower respiratory tract and is the most common reason for New Zealand children under one year of age to be admitted to hospital.  Maori and Pacific children, as well as children from lower socioeconomic backgrounds, are over-represented in these figures.

Aside from its direct effect on the children presenting with the condition, bronchiolitis is a significant drain on scarce resources. It follows that, to improve children’s outcomes and reduce wasteful spending, a reduction in admissions is a good place to start.

Cure Kids has awarded Dr Stuart Dalziel from Starship Children’s Hospital a grant to investigate the effectiveness of using a combination of nebulised adrenaline and a corticosteroid to treat children who present with symptoms of bronchiolitis at Accident and Emergency.

Preliminary findings from a similar research project undertaken in Canada show that, on their own, adrenaline or corticosteroids were ineffective.  However, when the drugs were combined, there was a 35% decrease in hospital admissions compared to the placebo group.

These findings have informed the development of a similar trial here.  Dr Dalziel and his team will enrol 300 children under one year of age, half of which will receive the combination of drugs, while the other half will receive a placebo.  The trial design enables similar trials overseas – the US, UK and Canada – to combine data, helping to increase confidence in the findings.

The trial will take place over three years, and a positive result would make for a compelling argument for changing current treatment guidelines.