KIDS-STEP Study | Information and results

Adults with lung infections recover more quickly if they are given anti-inflammatory medication (cortisone), such as bethamethasone. There is little information on this for children. If the effect is similar to that in adults, a milder course of the disease after hospitalisation and a shorter hospital stay can be expected. The aim of this study was to find out whether the administration of the active ingredient betamethasone can help children hospitalised with pneumonia to recover more quickly without increasing the risk of re-admission to hospital.

Children aged between 6 months and 14 years who were hospitalised for pneumonia took part in the international study. 9 hospitals in Switzerland and 4 hospitals in Germany took part in this study. The children were given either betamethasone or a placebo for 2 days in addition to their usual standard treatment. Allocation to the betamethasone or placebo group was done randomly by drawing lots (randomisation). It was then measured how quickly the children's health stabilised (e.g. normal heart and respiratory rate and oxygen levels) and whether they had to return to hospital within 4 weeks of entering the study. This was asked during telephone calls in weeks 1, 2 and 4.

A total of 510 children took part in the study over a period from September 2018 to February 2024. It was randomly decided that 249 children would receive betamethasone and 260 children placebo. Both groups (betamethasone and placebo) had similar characteristics. Half of the children on betamethasone stabilised after 45.7 hours. The time to clinical stabilisation in the placebo group was 41.2 hours on average. This time difference is not statistically significant. There was also no clear difference in the risk of re-admission to hospital: 7.2 % of children in the betamethasone group had to be re-admitted, compared with 5.4 % in the placebo group. Other factors such as the length of hospitalisation, the need for antibiotic treatment, the occurrence of undesirable clinical events and the use of healthcare services were similar in both groups. There were no differences in the safety and tolerability of the treatment in both groups.

The results show that betamethasone does not lead to faster stabilisation or earlier discharge from hospital in children with pneumonia. There is no benefit to routinely using betamethasone in children with non-life-threatening pneumonia.