What does this research mean for the field?

Preschool children with severe, recurrent wheeze are frequently treated with high numbers of oral corticosteroid courses during acute attacks, irrespective of their clinical phenotype or atopic status. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the burden of oral corticosteroid use and examine whether prescribing patterns differ across inflammatory and atopic phenotypes in preschool children with recurrent, severe wheeze.

August 22, 2026Archives of Disease in ChildhoodOpen Access

High oral corticosteroid use during acute attacks of preschool wheeze irrespective of clinical phenotype

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Authors

KHKushalinii HillsonLung Institute KOKarina M OritzImperial College London SHSophie HayImperial College London

Discussion

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Implication

Prospective study finds high oral corticosteroid exposure regardless of atopic status or eosinophil count in preschool wheeze, suggesting widespread unguided steroid prescribing.

Key Points

To evaluate the burden of oral corticosteroid use and examine whether prescribing patterns differ across inflammatory and atopic phenotypes in preschool children with recurrent, severe wheeze.
Single-centre prospective study of 100 children (median age 3.5 years, IQR 2.8–4.9; 51% male) with severe, recurrent preschool wheeze referred to a tertiary respiratory centre.
Conducted symptom questionnaires, point-of-care blood eosinophil count (BEC), and aeroallergen sensitisation testing during outpatient clinic appointments.
Children received a median of 10 lifetime oral corticosteroid courses (IQR 6–18) and a median of 5 courses (IQR 3–7) in the preceding 12 months.
Atopic children demonstrated significantly higher baseline BEC than non-atopic children for both clinical atopy (median 0.65 vs 0.3×10⁹/L; p=0.003) and objective atopy (median 0.7 vs 0.3×10⁹/L; p<0.0001).
Acute oral corticosteroid use did not differ across BEC levels, clinical atopy, objective sensitisation, or combined phenotypes over the child's lifetime or in the past 12 months.

Cite This Study

Hillson et al. (2026) studied this question.

synapsesocial.com/papers/6a895e96ca7ade938187cae2 https://doi.org/10.1136/archdischild-2026-330534

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Implication

Prospective study finds high oral corticosteroid exposure regardless of atopic status or eosinophil count in preschool wheeze, suggesting widespread unguided steroid prescribing.

High oral corticosteroid use during acute attacks of preschool wheeze irrespective of clinical phenotype

Discussion

Member takes

Implication

Key Points

Cite This Study

High oral corticosteroid use during acute attacks of preschool wheeze irrespective of clinical phenotype

Discussion

Member takes

Implication

Key Points

Cite This Study

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