Treatment of recurrent acute wheezing episodes in infancy with oral salbutamol and prednisolone

Fox, Grenville; Marsh, Michael P.; Milner, Anthony

doi:10.1007/bf01955192

Cited by 47 publications

(45 citation statements)

References 23 publications

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“…Thus, infants possess functional b 2 -receptors from birth, and stimulation of these receptors can produce the same effects as in older children, although paradoxical responses to inhaled b 2 -agonists have been reported in infants [50,101]. Oral administration of b 2 -agonist is also effective but is limited by systemic side-effects [102]. Intravenous infusion of b 2 -agonists has only shown an advantage over hourly inhaled treatment in very severe acute wheeze in young children [103].…”

Section: Pharmacological Therapymentioning

confidence: 99%

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Brand¹,

Baraldi²,

Bisgaard³

et al. 2008

Eur Respir J

752

759

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There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis.Based on the limited evidence available, inhaled short-acting b 2 -agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop.Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit.Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.

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Section: Pharmacological Therapymentioning

confidence: 99%

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Brand¹,

Baraldi²,

Bisgaard³

et al. 2008

Eur Respir J

752

759

View full text Add to dashboard Cite

show abstract

“…The short-term addition of a controller medication -inhaled glucocorticosteroid, leukotriene modifier, or oral glucocorticosteroid -has demonstrated no effects on wheezing symptoms or progression to asthma [94][95][96][97][98][99][100][101][102] . However, in one study treating wheezing episode with 1,500 µg of fluticasone proprionate daily for 10 days reduced the need for oral glucocorticosteroids for the episode (18% in the untreated arm versus 8% in the treated arm) 103 .…”

Section: Duration and Adjustments To Treatmentmentioning

confidence: 99%

“…Although such interventions have been shown to result in statistically significant benefits in several studies, their clinical benefit, particularly on such endpoints as hospitalizations and longer-term outcomes, have not been impressive [95][96][97][98][99][100][101][102]112 . The exception to this pattern is one study of 1,500 µg of fluticasone Regardless of the type of intervention, with either glucocorticosteroids or leukotriene modifiers, the severity of symptoms at the time the therapy is initiated must be carefully monitored.…”

Section: Additional Treatmentmentioning

confidence: 99%

Global strategy for the diagnosis and management of asthma in children 5 years and younger

Pedersen

Hurd

Lemanske

et al. 2010

Pediatric Pulmonology

270

207

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Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalions1. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non‐specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms‐only descriptive approach that includes the definition of various wheezing phenotypes has been recommended2. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information.In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in healthcare access and delivery. Patients in this age group are often managed by pediatricians and general practitioners routinely faced with a wide variety of issues related to childhood diseases. Pediatr Pulmonol. 2011; 46:1–17. © 2010 Wiley‐Liss, Inc.

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“…[473][474][475][476][477] Because of the high potential for side-effects, especially if the treatment is continued inappropriately or is given frequently, familyadministered OCS or high dose ICS should be considered only where the health care provider is confident that the medications will be used appropriately, and the child is closely monitored for side-effects (see p.116. Emergency treatment and initial pharmacotherapy).…”

Section: Family/carer-initiated Corticosteroidsmentioning

confidence: 99%

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Kumbhare

Strange

2018

Southern Medical Journal

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Treatment of recurrent acute wheezing episodes in infancy with oral salbutamol and prednisolone

Abstract: This study demonstrates that oral salbutamol is beneficial in the treatment of acute episodes of wheezing in infancy. A combination of oral salbutamol and oral prednisolone appeared to have no additional benefit over treatment with oral salbutamol alone.

Cited by 47 publications

References 23 publications

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Global strategy for the diagnosis and management of asthma in children 5 years and younger

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

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