Expert group recommendation on inhaled mucoactive drugs in pediatric respiratory diseases: an Indian perspective

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Meenu Singh1, Sneha Varkki2, Ilin Kinimi3

  • 1Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.

Frontiers in Pediatrics
|December 19, 2023
PubMed

Insights

Inhaled mucoactive drugs can aid children with cystic fibrosis (CF) and may benefit those with non-CF bronchiectasis and primary ciliary dyskinesia (PCD). Evidence is insufficient for other pediatric respiratory conditions.

Area of Science:

  • Pediatric Respiratory Medicine
  • Pharmacology
  • Clinical Consensus

Background:

  • No existing Indian guidelines address inhaled mucoactive drug use in pediatric respiratory diseases.
  • A need exists for practical guidance for Indian pediatricians.

Purpose of the Study:

  • To develop a consensus document for managing pediatric respiratory conditions with mucoactive drugs.
  • To aid clinical decision-making for pediatricians in India.

Main Methods:

  • Expert panel review and consensus meeting.
  • Systematic literature search of major databases (PubMed, Cochrane, Scopus, Embase).
  • Grading of evidence and recommendations for inhaled mucoactive agents.

Main Results:

  • Inhaled mucoactive drugs (hypertonic saline, mannitol, dornase alfa) improve mucociliary clearance in pediatric cystic fibrosis (CF).
  • Hypertonic saline shows potential benefit in non-CF bronchiectasis, acute bronchiolitis, and primary ciliary dyskinesia (PCD).

Conclusions:

  • Evidence supports inhaled mucoactive drugs for CF, with potential for hypertonic saline in non-CF bronchiectasis, acute bronchiolitis, and PCD.
  • Current evidence is insufficient for use in asthma, acute wheezing, tracheomalacia, and esophageal atresia with tracheoesophageal fistula (EA with TEF).
Abstract

Keywords:
Indiaconsensusinhaledmucoactivepediatricrespiratory disorders

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