Preschool Wheezing: Trajectories and Long-Term Treatment

Area of Science:

• Pediatrics
• Respiratory Medicine
• Allergology

Background:

• Infantile wheezing is highly prevalent, affecting up to one-third of children within their first three years.
• Identifying wheeze phenotypes and predicting asthma development remain challenging.
• Several factors, including breastfeeding, atopy, allergen exposure, environmental tobacco smoke, and viral infections, influence wheezing onset and persistence.

Purpose of the Study:

• To analyze factors predisposing to the onset and persistence of infantile wheezing.
• To evaluate the efficacy of inhaled corticosteroids and other therapeutic options for preschool wheeze.
• To emphasize the importance of adherence and correct medication administration in managing childhood wheeze.

Main Methods:

• Review of identified wheeze phenotypes based on symptom patterns.
• Analysis of predisposing factors for wheezing onset and persistence.
• Evaluation of treatment guidelines for inhaled corticosteroids and montelukast.

Main Results:

• Inhaled corticosteroids are the first-line controller treatment for all preschool children with wheeze.
• Atopic children particularly benefit from inhaled corticosteroids, experiencing fewer exacerbations.
• Montelukast and intermittent inhaled corticosteroid use are alternative therapeutic options.

Conclusions:

• Accurate assessment of asthma development risk in infants is difficult.
• Overuse of inhaled steroids should be avoided.
• Regular checks of treatment adherence and correct medication administration are essential for effective management of childhood wheeze.