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Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus
Susanna Esposito1, Marcus Herbert Jones2, Wojciech Feleszko3
1Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, 43126 Parma, Italy.
Insights
Preventing recurrent respiratory tract infections (RTIs) in children remains challenging. While immunotherapy (OM-85) shows promise, evidence for probiotics and vitamin D is inconclusive, emphasizing traditional prevention methods.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Recurrent respiratory tract infections (RTIs) are common in healthy children.
- Effective prevention strategies for children prone to RTIs are limited.
- Includes children with atopic/allergic conditions and asthma.
Purpose of the Study:
- To present an international consensus on preventing recurrent RTIs in children.
- To evaluate current and emerging prevention approaches.
- To identify evidence-based recommendations for clinical practice.
Main Methods:
- Review of available literature and clinical trials on RTI prevention.
- Consensus-building among international experts.
- Assessment of efficacy and safety profiles of various interventions.
Main Results:
- OM-85 immunotherapy has demonstrated efficacy and safety for preventing RTIs.
- Evidence for probiotics and vitamin D in preventing RTIs is inconclusive regarding optimal strains, dosage, and administration.
- Traditional methods like vaccination, environmental factor reduction, and hand hygiene remain crucial.
Conclusions:
- OM-85 is a viable option for preventing recurrent RTIs in children.
- Further research is needed to clarify the role and optimal use of probiotics and vitamin D.
- Continued emphasis on vaccination, environmental control, and hygiene is essential for RTI prevention.
Abstract:
In healthy infants and young children, the development of respiratory tract infections (RTIs) is extremely common. In this paper, we present an international consensus of the available approaches for the prevention of recurrent RTIs in children, including the atopic/allergic ones as well as those with asthma. Few convincing measures for reducing the frequency and clinical relevance of recurrent respiratory episodes in RTI-prone children have been developed until now. Among the most recently suggested measures, immunotherapy is attractive, but only for OM-85 is there a sufficient number of well-conducted clinical trials confirming efficacy in RTIs prevention with an adequate safety profile. In the case of probiotics, it is not clear which bacteria can offer the best results and which dosage and schedule of administration are the most effective. The problems of dosage and the schedule of administration are not solved also for vitamin D, despite some promising efficacy results. While we wait for new knowledge, the elimination or reduction as much as possible of the environmental factors that favor RTIs, vaccination when available and/or indicated, and the systematic application of the traditional methods for infection prevention, such as hand washing, remain the best measures to prevent recurrent infections in RTI-prone children.
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