Abstract

Bronchiolitis is result of inflammatory response of the body in the respiratory tract leading to the obstruction of the small airways (bronchioles and alveoli), in young children of less than two years age. Fever, nasal discharge, tachypnea, expiratory wheeze and/or fine inspiratory crackles are clinical features of this disease1.

Objective: To compare the mean clinical severity score and hospital stay after montelukast versus placebo as an adjunct for management of acute bronchiolitis in children.

Duration of Study: February 23, 2017 to August 23, 2017

Study Design: Randomized controlled trial

Methodology: All 100 patients fulfilling the operational definition of acute bronchiolitis admitted in pediatric emergency were evaluated by the primary investigator. Children were given Montelukast 5mg chewable form as an adjunct to standard treatment in interventional group and children in non-interventional group were given placebo as an adjunct to standard treatment. Clinical severity score was assessed and all children were admitted in pediatric ward and were followed-up there for 3 days. After 3 days of treatment, clinical severity score was again measured. Data were analyzed using SPSS v23.0. Post-stratification, independent sample t-test was applied. p-value ≤0.05 was considered significant.

Results: Of total 100 patients 50 patients were given Montelukast and 50 patients were given placebo. The Mean clinical severity score of patients in group A was 0.07±0.03 and in group B was 0.48±0.32 with p-value of 0.000 which is statistically significant. The mean hospital stay of patients in group A was 36.4±3.8 hours and in group B was 54.3±3.7 hours with p-value of 0.000 which is statistically significant.

Conclusion: Montelukast can be recommended to physicians treating bronchiolitis patients. It can significantly reduce the signs and symptoms of the disease, thus decreasing the disease severity along with the stay in the hospital. Study should be done on a larger population in various cities of our country to see the effect of montelukast on various populations.

Keywords: Bronchiolitis, Montelukast, Clinical Severity Score, Medically fit for Discharge