Nebulised budesonide has no clinically meaningful benefit in the acute phase of respiratory syncytial virus bronchiolitis, either in hastening discharge from hospital or in reducing long-term morbidity, say Leeds researchers. In a study involving 161 children, there was no difference in the incidence of coughing and wheezing, and similar numbers of days were spent in hospital and to become symptom-free. The researchers speculate that this is because of poor drug deposition in the lungs, which might be exacerbated by tachypnoea and increased secretions caused by the illness (Archives of Disease in Childhood 2000;82:126).