Response to budesonide among atopic and non-atopic infants/preschoolers with recurrent wheezing.
BACKGROUND
The treatment in non-atopic young children with recurrent wheezing remains controversial.


OBJECTIVE
The aim of the study was to compare the response of inhaled budesonide in atopic versus non-atopic infants/preschoolers with recurrent wheezing (more than three episodes in the last year or one episode per month in the last three months).


METHODS
One hundred and seventy three infants/preschoolers (mean age 1.58+/-0.9 yrs) with recurrent wheezing without previous use of inhaled corticosteroids were enrolled and divided into two categories: atopics (eosinophils in peripheral blood > or =4%) and non-atopics (<4%). Both groups were treated with budesonide (200 mcg bid delivered by MDI and spacer) for three months. The primary outcome was the prevalence of wheezing exacerbation episodes at the end of the treatment.


RESULTS
Thirty-seven out of 173 (21.4%) were atopics and they were significantly younger, more frequently with a father with asthma, maternal grandparents with asthma and rhinitis, paternal and maternal grandparents with eczema, and higher number of wheezing episodes in the last year than non-atopics. At the end of the study, among those with good compliance (>70% of the weekly doses), the proportion of wheezing episodes were similar among atopics and non-atopics (57.7% vs. 44.1%, p=0.25, respectively); the number of exacerbations requiring emergency department (ED) visits and hospital admission were also similar.


CONCLUSIONS
Regular budesonide therapy may decrease the episodes of wheezing in infants/preschoolers with recurrent wheezing, independently of atopy.
Campusano
L
L
Department of Pediatrics, Universidad de Antofagasta, Antofagasta, Chile.
Pastenes
M
M
Fontecilla
C
C
Escalona
J
J
Salazar
C
C
Castro-Rodriguez
J A
JA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019819:Budesonide / Q000494:pharmacology / Q000627:therapeutic use*; D002675:Child, Preschool; D003371:Cough / Q000453:epidemiology; D004802:Eosinophilia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007223:Infant; D008297:Male; D008423:Maternal Age; D011446:Prospective Studies; D012008:Recurrence; D012135:Respiratory Sounds / Q000187:drug effects*; D012959:Socioeconomic Factors
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D019819:Budesonide