Viral-induced wheezing episodes in preschool children: approaches to therapy.
OBJECTIVE
The high prevalence of wheezing illnesses in the preschool age group and the heterogeneity of wheezing phenotypes early in life combine to present significant challenges in the clinical management of this problem.


RESULTS
Recent studies have examined multiple therapeutic strategies to reduce the frequency and/or severity of viral-triggered wheezing episodes in young children. Clinical trials demonstrate various degrees of clinical benefit associated with daily use of inhaled corticosteroids or leukotriene receptor antagonists in terms of episode prevention and attenuation, and with episodic therapy with high-dose inhaled corticosteroids or leukotriene receptor antagonists in terms of episode attenuation. Recent evidence has brought into question the efficacy of systemic corticosteroid therapy as an element of inpatient care for viral-induced wheezing.


CONCLUSIONS
The optimal management strategy for virus-induced wheezing in early life remains elusive. Future research in this area should incorporate consideration of the heterogeneous nature of this complex syndrome.
Bacharier
Leonard B
LB
Department 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
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D012135:Respiratory Sounds / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D020024:Leukotriene Antagonists