Background. Treatment of bronchilitis (bronch) is supportive. Infants with RSV bronch have low serum vit A; we postulated that vit A could be useful in the treatment of bronch.

Subjects. Infants with first bronch episode and ill for <8 days.

Interventions. Randomized double blind, placebo controlled paired sequential trial. Clinical score, SaO2 blood (for retinol and viral serology) and nasopharyngeal wash (ELISA RVA and viral culture) were obtained at the time of entry. Retinyl palmitate 50,000 IU and 100,000 IU were given PO to infants 2-3 and 4-12 months of age, respectively, in addition to standard treatment. End points were duration of hospital stay and need of intensive care for hospitalized patients, and need of subsequent hospitalization for the same bronch episode for ambulatory infants.

Results. Of 131 patients included 127 completed the study; there were 54 pairs. 25 ambulatory and 29 hospitalized. One study and one control ambulatory infants were subsequently hospitalized. In hospitalized infants vit A was superior in 14 study pairs, and placebo in 11 control pairs (n.s.). No untoward effects were recorded. Serum retinol was <0.7 μmol/L in 58% of infants: 69 infants had RSV, and 9 CMV infections.

Conclusion. Vit A was not beneficial or detrimental in infants with bronchiolitis. We presently investigate possible longer term effects of vit A in these patients.