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Viral-induced wheezing episodes in preschool children: approaches to therapy

Leonard B Bacharier1

  • 1Department of Pediatrics, Division of Allergy, Immunology, and Pulmonary Medicine, Washington University School of Medicine, St Louis Children's Hospital, St Louis, Missouri 63110, USA. Bacharier_L@kids.wustl.edu

Current Opinion in Pulmonary Medicine
|October 10, 2009
PubMed

Insights

Managing viral-induced wheezing in young children is challenging due to varied symptoms. Current treatments like inhaled corticosteroids show some benefit, but optimal strategies for preventing wheezing episodes remain unclear.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Immunology

Background:

  • Wheezing illnesses are common in preschoolers, with diverse early-life phenotypes complicating management.
  • Viral infections frequently trigger wheezing episodes in young children.

Purpose of the Study:

  • To review current therapeutic strategies for viral-triggered wheezing in young children.
  • To evaluate the efficacy of various treatments in preventing and attenuating wheezing episodes.

Main Methods:

  • Review of recent clinical trials examining therapeutic interventions for viral-induced wheezing.
  • Analysis of evidence regarding inhaled corticosteroids, leukotriene receptor antagonists, and systemic corticosteroids.

Main Results:

  • Daily inhaled corticosteroids and leukotriene receptor antagonists show varying degrees of benefit in preventing and attenuating episodes.
  • Episodic high-dose inhaled corticosteroids or leukotriene receptor antagonists may attenuate wheezing episodes.
  • Recent evidence questions the effectiveness of systemic corticosteroids for inpatient care of viral-induced wheezing.

Conclusions:

  • The optimal management for virus-induced wheezing in early life is not yet established.
  • Future research must address the heterogeneous nature of this syndrome for improved treatment strategies.
Abstract

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