Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomes

Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Mesquita-Bastos, José; Postiaux, Guy

doi:10.1007/s00431-017-3003-z

Cited by 15 publications

(10 citation statements)

References 33 publications

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“…For this update, we screened 2486 citations published since the original search (June 2016) and included 13 additional studies (8 RCTs, 5 observational studies) in 14 publications. 16 – 29 The study characteristics and quality assessment for studies included in the CER can be found in the AHRQ report, 11 and studies added in this update can be found in Table 1 . Cumulatively, there were 95 (86%) mostly fair-quality studies: 65 RCTs and 30 observational studies ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review

et al. 2018

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ObjectiveAntibiotic overuse contributes to antibiotic resistance and adverse consequences. Acute respiratory tract infections (RTIs) are the most common reason for antibiotic prescribing in primary care, but such infections often do not require antibiotics. We summarized and updated a previously performed systematic review of interventions to reduce inappropriate use of antibiotics for acute RTIs.MethodsTo update the review, we searched MEDLINE®, the Cochrane Library (until January 2018), and reference lists. Two reviewers selected the studies, extracted the study data, and assessed the quality and strength of evidence.ResultsTwenty-six interventions were evaluated in 95 mostly fair-quality studies. The following four interventions had moderate-strength evidence of improved/reduced antibiotic prescribing and low-strength evidence of no adverse consequences: parent education (21% reduction, no increase return visits), combined patient/clinician education (7% reduction, no change in complications/satisfaction), procalcitonin testing for adults with RTIs of the lower respiratory tract (12%–72% reduction, no increased adverse consequences), and electronic decision support systems (24%–47% improvement in appropriate prescribing, 5%–9% reduction, no increased complications).ConclusionsThe best evidence supports use of specific educational interventions, procalcitonin testing in adults, and electronic decision support to reduce inappropriate antibiotic prescribing for acute RTIs without causing adverse consequences.

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Section: Resultsmentioning

confidence: 99%

Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review

et al. 2018

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“…Viral infections are predominant, but bacterial super-infections may frequently appear. Consequently, there is an overuse/misuse of antibiotics by primary care doctors that in turn induces antibiotic resistance [34,35]. Moreover, biofilm causes frequent antibiotic unsuccess and 25-45% of children with severe RRI need surgical intervention [36,37].…”

Section: Recurrent Respiratory Infectionsmentioning

confidence: 99%

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Varricchio¹,

Mantia

Brunese³

et al. 2020

Ital J Pediatr

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The upper airways (UA) should be considered as a functional unit. Current functional anatomy divides URT in three, mutually dependent, "junction boxes": i) the ostio-meatal complex (OMC), ii) the spheno-ethmoidal recess (SER), and iii) the rhinopharynx (RP). Correct ventilation and effective mucociliary clearance of these sites significantly affect the healthy physiology of the entire respiratory system. The OMC, SER, and RP obstruction is the first pathogenic step in the inflammatory/infectious cascade of UA disorders. The inflammation of the respiratory mucosa is the main pathogenic factor for airway obstruction. Moreover, bacterial biofilm (a strategy modality of bacterial survival) is an important local cause of systemic antibiotic ineffectiveness, recurrent infections, and antibiotic resistance. Health microbiota guarantees UA wellness; on the contrary, dysbiosis promotes and worsens UA infections. Allergy, namely type 2 inflammation, is a common cause of UA obstruction such as promoting in turn infections. Fiberoptic endoscopy is a mandatory diagnostic tool in clinical practice. Nasal cytology, mainly concerning flow cytometry, allows defining rhinitis phenotypes so allowing a precision medicine approach. Several conventional therapeutic approaches are available, but efficacy and safety should be ever properly considered before the prescription. Also, complementary medicine plays a fruitful role in the management of UA diseases. National and real-world studies are reported and discussed as they may be useful in daily clinical practice.

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“…8 Also, regarding RRC, there is some evidence of its effect in clearing the upper respiratory tract, and very encouraging results given that it is a non-pharmacological form of intervention without clinically relevant side-effects. 23 , 28 …”

Section: Discussionmentioning

confidence: 99%

“… 10 , 20 RRC was accomplished by instillation of isotonic saline solution (0.9% NaCl) through the nostrils, followed by mouth closure, forcing inspiration through the nasals cavities and removing secretions from this area to the oropharyngeal cavity. 21 , 22 , 23 These maneuvers were carried out during consecutive breathing cycles in order to promote the mobilization of secretions towards the proximal airways. This stimulated the mechanical receptors and made the children cough spontaneously.…”

Section: Methodsmentioning

confidence: 99%

Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age — A randomized control trial

Pinto

Alexandrino

Correia-Costa

et al. 2021

Hong Kong Physiother. J.

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Objective: The aim of this study was to compare the role of a chest physiotherapy (CP) intervention to no intervention on the respiratory status of children under two years of age, with mild-to-moderate bronchiolitis. Methods: Out of 80 eligible children observed in the Emergency Room, 45 children completed the study with 28 randomized to the intervention group and 17 to the control group. The intervention protocol, applied in an ambulatory setting, consisted of combined techniques of passive prolonged slow expiration, rhinopharyngeal clearance and provoked cough. The control group was assessed with no chest physiotherapy intervention. The efficacy of chest physiotherapy was assessed using the Kristjansson Respiratory Score at the admission and discharge of the visit to the Emergency Room and during clinical visits at day 7 and day 15. Results: There was a significant improvement in the Kristjansson Respiratory Score in the intervention group compared to the control group at day 15 [1.2 (1.5) versus 0.3 (0.5); [Formula: see text]-value[Formula: see text], in the control and intervention groups, respectively], with a mean difference (95% CI) of [Formula: see text] ([Formula: see text] to [Formula: see text]). Conclusion: Chest physiotherapy had a positive impact on the respiratory status of children with mild-to-moderate bronchiolitis. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04260919 .

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Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomes

Cited by 15 publications

References 33 publications

Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review

Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age — A randomized control trial

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