Dexamethasone in bronchopulmonary dysplasia.

Dexamethasone is useful for the treatment of bronchopulmonary dysplasia in premature infants and it is likely that its use will increase. Several side effects have been reported, including an increased incidence of infection. Because glucocorticoids are known to produce neutrophilia in adults (probably through a combination of increased release of neutrophils from the marrow, and prolongation of their circulating half life), and because neutrophilia is sometimes an indication of infection in the newborn, it is possible that a false suspicion of the presence of infection may be raised in babies being treated with steroids. We describe the neutrophil counts of eleven babies whom we have treated with steroids during the past year. Each baby was treated with 0-6 mg/kg/day of dexamethasone for one week. The table shows the neutrophil counts before and during the period of treatment with steroids. In four babies a pronounced neutrophilia (>20x 109/l) developed during treatment. In three of these the blood film was reported as shifted to the left with a band neutrophil:neutrophil ratio greater than 0-25:1. In two babies a left shift with an increase in band neutrophil:neutrophil ratio occurred in the absence of neutrophilia. None of these babies showed other signs of infection, no pathogens were grown on serial blood