In preschool-age children with moderate-to-severe virus-induced wheezing, preemptive treatment with high-dose fluticasone as compared with placebo reduced the use of rescue oral corticosteroids. Treatment with fluticasone was associated with a smaller gain in height and weight. Given the potential for overuse, this preventive approach should not be adopted in clinical practice until long-term adverse effects are clarified. (ClinicalTrials.gov number, NCT00238927.)

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that additional factors are required. Our study also confirmed the association of FLG mutations and early-onset infantile eczema, which is in line with previous work. 6 Our ability to interrogate the role of sensitization in the relationship between FLG mutations and food allergy in a large population-based, age-matched, challenge-proved food allergy cohort is a major and novel strength of this work. There is some potential participation bias among negative control subjects (higher immediate family history of allergic diseases compared with the general population); however, such a bias would be more likely to create a false-negative than a false-positive association.In conclusion, FLG mutations do not increase the risk of food allergy over and above that of food sensitization among 1-year-old infants. These results confirm the biological plausibility that decreased skin barrier function increases the risk of food sensitization in early life, but other as yet undetermined factors are important in the conversion from food sensitization to allergy.We acknowledge the contribution of all the parents and children who participated in the study. We thank Dr Benjamin Ong for assistance with Sequenom assay design and the Royal Children's Hospital Outpatient Pathology staff for blood collection. We thank ALK-Abell o S.A., Madrid, Spain, for supplying the SPT reagents and the HealthNuts safety committee: Associate Professor Noel Cranswick

We report the first case of anaphylaxis to oral vancomycin in a cystic fibrosis patient with severe and relapsing Clostridium difficile infection (CDI) refractory to metronidazole. The patient's colitis has been successfully treated with a combination of intravenous metronidazole and tigecycline.