O uso de corticosteroide oral para sibilância em lactentes é abusivo?

Neto, Herberto José Chong

doi:10.1590/s1806-37132011000100019

Cited by 4 publications

(4 citation statements)

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“… 17 If infants are excessively treated with oral corticosteroids, this can be explained by the fact that some centers in Brazil provide asthma medications through the public health network or because the guidelines for asthma management are not known or are inadequately followed. 18 In Cuiabá, there is no public health program to monitor these children and parents preferentially seek emergency units, which could explain the large consumption of this type of medication in wheezing exacerbations to the detriment of preventive treatment for recurrence.…”

Section: Discussionmentioning

confidence: 99%

“… 17 Se os lactentes são tratados excessivamente com corticosteroide oral isto pode ser explicado pelo fato de que alguns centros no Brasil disponibilizam medicações para asma na rede pública ou porque as diretrizes para o manejo da asma não são conhecidas ou são inadequadamente observadas. 18 Em Cuiabá, não há um programa de saúde pública para acompanhamento destas crianças e os pais procuram preferencialmente as unidades de emergência, o que justificaria o grande consumo deste medicamento nas exacerbações de sibilância, em detrimento ao tratamento preventivo de sua recorrência.…”

Section: Discussionunclassified

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Prevalência e características clínicas da sibilância em crianças no primeiro ano de vida, residentes na cidade de Cuiabá, Mato Grosso, Brasil1

Moraes

Takano

Mallol

et al. 2014

Revista Paulista de Pediatria

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OBJECTIVE: To evaluate the prevalence and the clinical characteristics of wheezing in infants aged 12 to 15 months in the city of Cuiabá, Mato Grosso State, Midwest Brazil. METHODS: Parents and/or guardians of infants were interviewed and completed a written standardized questionnaire of the Estudio Internacional de Sibilancia en Lactantes (EISL) - phase 3 at primary healthcare clinics at the same day of children vaccination or at home, from August of 2009 to November of 2010. RESULTS: 1,060 parents and/or guardians completed the questionnaire, and 514 (48.5%) infants were male. Among the studied infants, 294 (27.7%) had at least one episode of wheezing during the first year of life, beggining at 5.8±3.0 months of age, with a predominance of male patients. The prevalence of occasional wheezing (<3 episodes of wheezing) was 15.0% and recurrent wheezing (≥3 episodes) was 12.7%. Among the infants with recurrent wheezing, the use of inhaled β2-agonist, oral corticosteroid, leukotriene receptor antagonist, as well as night symptoms, respiratory distress, and hospitalization due to severe episodes were significantly more frequent. Physician-diagnosed asthma was observed in 28 (9.5%) of the wheezing infants. Among the wheezing infants, 80 (27.7%) were diagnosed with pneumonia, of whom 33 (11.2%) required hospitalization; neverthless, no differences between occasional and recurrent wheezing infants were found. CONCLUSIONS: The prevalence of recurrent wheezing and physician-diagnosed asthma in infants were lower compared with those observed in other Brazilian studies. Recurrent wheezing had early onset and high morbity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

Prevalência e características clínicas da sibilância em crianças no primeiro ano de vida, residentes na cidade de Cuiabá, Mato Grosso, Brasil1

Moraes

Takano

Mallol

et al. 2014

Revista Paulista de Pediatria

View full text Add to dashboard Cite

show abstract

“…If infants are excessively treated with oral corticosteroids, this can be explained by the fact that some centers in Brazil provide asthma medications through the public health network or because the guidelines for asthma management are not known or are inadequately followed 18. In Cuiabá, there is no public health program to monitor these children and parents preferentially seek emergency units, which could explain the large consumption of this type of medication in wheezing exacerbations to the detriment of preventive treatment for recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Observou-se não haver diferença significativa com o uso de prednisolona nos pré-escolares com sibilância por vírus em relação ao tempo de hospitalização e ao escore de sintomas, mesmo naqueles que apresentaram um índice preditivo positivo para asma (IPA) 17. Se os lactentes são tratados excessivamente com corticosteroide oral isto pode ser explicado pelo fato de que alguns centros no Brasil disponibilizam medicações para asma na rede pública ou porque as diretrizes para o manejo da asma não são conhecidas ou são inadequadamente observadas 18. Em Cuiabá, não há um programa de saúde pública para acompanhamento destas crianças e os pais procuram preferencialmente as unidades de emergência, o que justificaria o grande consumo deste medicamento nas exacerbações de sibilância, em detrimento ao tratamento preventivo de sua recorrência.…”

Section: Discussionunclassified