Dexamethasone for bronchiolitis.

To the Editor: The prospective trial of dexamethasone for bronchiolitis in infants, conducted by the Bronchiolitis Study Group of the Pediatric Emergency Care Applied Research Network (PECARN) and reported by Corneli et al. (July 26 issue),1 appears to demonstrate a lack of efficacy of oral dexamethasone in infants with a first episode of wheezing diagnosed as bronchiolitis. Although the authors aptly conclude that dexamethasone did not provide a benefit in the first 7 days after treatment, they fail to address the fact that treatment with oral steroids may prevent recurrent wheezing in the months after infection, particularly in first-time wheezing induced by rhinovirus.2 This is significant, given that rhinovirus-induced wheezing is the second most common cause of early wheezing and is an emerging risk factor for recurrent wheezing.3,4 Are there follow-up data on the condition of the children studied that can address this question?