Related Experiment Video

Updated: Aug 2, 2026

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
05:31

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels

Published on: August 7, 2017

Question 4: Is there a role for antibiotics in infantile wheeze?

Fernando M de Benedictis1, Ines Carloni2, Roberto Guidi2

  • 1Salesi Children's Hospital Foundation, Ancona, Italy.

Paediatric Respiratory Reviews
|December 4, 2019
PubMed

Insights

Antibiotic treatment for acute wheezing in young children yielded controversial results. Current evidence suggests azithromycin may benefit only those with severe, recurrent episodes, not general use.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Microbiology

Background:

  • Acute wheezing is common in young children, leading to significant morbidity and healthcare use.
  • Respiratory viruses are known triggers, but airway bacteria also play a role, alone or with viruses.
  • The impact of bacteria on acute asthma exacerbations is increasingly recognized.

Purpose of the Study:

  • To evaluate the effectiveness of antibiotic interventions targeting airway bacteria in preschool children with acute wheezing.
  • To assess the potential of antibiotics like azithromycin in reducing wheezing severity and recurrence.
  • To analyze the controversial findings from recent randomized controlled trials.

Main Methods:

  • Three randomized, double-blind, placebo-controlled trials were reviewed.
  • Studies focused on interventions with antibiotics (azithromycin) during acute wheezing episodes.
  • Data on wheezing severity and recurrence in preschool children were analyzed.

Main Results:

  • Results from the trials are controversial, indicating no universal benefit of antibiotic intervention.
  • Widespread antibiotic use for acute wheezing in young children is not supported by current evidence.
  • A potential benefit might exist for children experiencing severe, recurrent wheezing episodes.

Conclusions:

  • Antibiotic intervention with azithromycin cannot be broadly applied to all young children with acute wheezing.
  • The use of antibiotics should be reserved for specific cases, such as severe or recurrent wheezing.
  • Further research is needed on risk factors, virus-bacteria interactions, and biomarkers for targeted treatment.

Keywords:
AntibioticsAsthmaBacteriaPreschool childrenVirusWheezing

More Related Videos

Assessing Respiratory Immune Responses to Haemophilus Influenzae06:32

Assessing Respiratory Immune Responses to Haemophilus Influenzae

Published on: June 29, 2021

Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease02:34

Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease

Published on: May 10, 2024

Related Concept Videos

Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Microbiota of the Respiratory Tract01:29

Microbiota of the Respiratory Tract

The human respiratory tract, comprising the upper and lower segments, serves as a critical interface with the external environment. The upper respiratory tract (URT)—including the nostrils, sinuses, pharynx, and oropharynx—is heavily colonized by microbes, while the lower respiratory tract (LRT), composed of the larynx, trachea, bronchi, and lungs, was long thought to be sterile. However, recent molecular studies have revealed that the lungs are not devoid of microbes but act more like...
Asthma I: Introduction01:28

Asthma I: Introduction

Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...