A multicentre double blind trial in 800 infants with bronchiolitis aged between 6 weeks and 12 months compared placebo with nebulised adrenaline, oral dexamethasone, or both. Only the combination led to a decrease in the primary endpoint of reduced hospital admission up to 7 days after enrollment, with an absolute risk reduction of 9% (from 26 to 17%). They also found an apparent benefit from combined therapy on their secondary outcomes: infants in the combined treatment group were discharged earlier from medical care and resumed quiet breathing and normal feeding sooner than did those in the placebo group. When the analysis was adjusted for multiple comparisons, the apparent benefit did not reach statistical significance, leading the authors to recommend further study.
Epinephrine and Dexamethasone in Children with Bronchiolitis
N Engl J Med. 2009 May 14;360(20):2079-89