A Single Centre Randomised, Feasibility Study Using Point-of-care (POC) Testing for Respiratory Viruses to Direct Oral Corticosteroids Use in Preschool-aged Children With Acute Wheeze

What this Trial Is About

Young children aged 24 to 60 months who visit the emergency department with wheeze often experience attacks triggered by viral infections like the common cold. This research evaluates whether using rapid point-of-care viral testing can help decide if oral corticosteroids (OCS) should be given to treat mild-to-moderate wheeze attacks in this age group. The study aims to address the uncertainty about which children benefit from steroids, as current care varies and oral steroids may have side effects. The study is a single-center, open-label, randomized feasibility trial enrolling about 60 preschool children. After enrollment, children receive a nasal swab tested for respiratory viruses, with results available within 30 minutes. Based on these results, participants are randomized to either receive oral dexamethasone (a corticosteroid) or no corticosteroid treatment, both considered standard care options. All other emergency treatments continue as usual, and if dexamethasone is given but vomited within 30 minutes, it can be re-administered. Follow-up includes a clinical review at 2 working days and a phone call at 28 days post-enrollment, with optional finger prick blood testing for eosinophil count. Participants will be monitored through study visits and phone calls to track treatment adherence, acceptability of viral testing, and clinical outcomes. Researchers will collect data on recruitment, timeliness of procedures, and viral causes of wheeze. Families may also participate in interviews to provide feedback on the study. The total study duration includes initial emergency care and follow-up over 28 days, with safety and treatment decisions guided by the treating physician.

PREcision Medicine Directed Corticosteroids In Children With preSchool Wheeze