title: Symptomatic viral infection is associated with impaired response to treatment in children with acute asthma.
abstract: OBJECTIVE
  To examine the influence of viral respiratory infection (VRI) on treatment response in acute asthma in children.
  
  
  METHODS
  A total of 218 children (mean age, 6.6 years) with acute asthma were recruited. Symptoms were recorded, an asthma severity score was determined, and whenever possible, a per-nasal aspirate was obtained for detection of viruses. Each child's response to inhaled β(2)-agonists was assessed after 6, 12, and 24 hours.
  
  
  RESULTS
  The 168 children with VRI symptoms received more treatment with inhaled β(2)-agonists after 6 hours (P = .010), 12 hours (P = .002), and 24 hours (P = .0005) compared with the 50 children without such symptoms. Asthma severity did not differ between the 2 groups. A per-nasal aspirate was obtained from 77% of the children. The most frequently identified virus was rhinovirus (61.4%). Among children with symptoms of a VRI, those with rhinovirus had an impaired response to β(2)-agonists at 6 hours (P = .032).
  
  
  CONCLUSIONS
  Children with acute asthma and symptoms of VRI respond less effectively to β(2)-agonists after 6, 12, or 24 hours and thus may benefit from more intense therapy and monitoring.
authors.affiliation: Princess Margaret Hospital for Children, Perth, Australia. kristina.rueter@health.wa.gov.au
authors.forename: Kristina
authors.initials: K
authors.lastname: Rueter
authors.forename: Joelene
authors.initials: J
authors.lastname: Bizzintino
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Martin
authors.forename: Guicheng
authors.initials: G
authors.lastname: Zhang
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Hayden
authors.forename: Gary C
authors.initials: GC
authors.lastname: Geelhoed
authors.forename: Jack
authors.initials: J
authors.lastname: Goldblatt
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Laing
authors.forename: Peter N
authors.initials: PN
authors.lastname: Le Souëf
mesh_terms: D000208:Acute Disease; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications* / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications* / Q000821:virology*; D017211:Treatment Failure; D014777:Virus Diseases / Q000150:complications*
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists