Glucocorticoids for acute viral bronchiolitis in infants and young children.

CLINICAL QUESTION: Are glucocorticoids, alone or combined with bronchodilators, associated with reduced admission rates, length of stay, or improvements in clinical severity scores without increased adverse effects in infants and young children with acute viral bronchiolitis? BOTTOM LINE: There is no consistent clinically relevant association of single therapy with systemic or inhaled glucocorticoids and improved outcomes in either outpatient or inpatient settings. Exploratory evidence suggests that combined glucocorticoids and nebulized epinephrine may be associated with lower hospitalization rates in outpatients, but these findings must be interpreted cautiously.