title: Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants.
abstract: OBJECTIVE
  This study aimed to determine the prevalence and severity of recurrent wheezing (RW) defined as ≥3 episodes of wheezing, risk factors, and treatments prescribed during the first year of life in Latin American infants.
  
  
  METHODS
  In this international, cross-sectional, and community-based study, parents of 12,405 infants from 11 centers in 6 South American countries (Argentina, Brazil, Chile, Colombia, Peru, and Uruguay) completed a questionnaire about wheezing and associated risk/protective factors, asthma medications, and the frequency of and indications for the prescription of antibiotics and paracetamol during the first year of life.
  
  
  RESULTS
  The prevalence of RW was 16.6% (95% CI 16.0-17.3); of the 12,405 infants, 72.7% (95% CI 70.7-74.6) visited the Emergency Department for wheezing, and 29.7% (27.7-31.7) was admitted. Regarding treatment, 49.1% of RW infants received inhaled corticosteroids, 55.7% oral corticosteroids, 26.3% antileukotrienes, 22.9% antibiotics ≥4 times mainly for common colds, wheezing, and pharyngitis, and 57.5% paracetamol ≥4 times. Tobacco smoking during pregnancy, household income per month <1,000 USD, history of parental asthma, male gender, and nursery school attendance were significant risk factors for higher prevalence and severity of RW, whereas breast-feeding for at least 3 months was a significant protective factor. Pneumonia and admissions for pneumonia were significantly higher in infants with RW as compared to the whole sample (3.5-fold and 3.7-fold, respectively).
  
  
  CONCLUSIONS
  RW affects 1.6 out of 10 infants during the first year of life, with a high prevalence of severe episodes, frequent visits to the Emergency Department, and frequent admissions for wheezing. Besides the elevated prescription of asthma medications, there is an excessive use of antibiotics and paracetamol in infants with RW and also in the whole sample, which is mainly related to common colds.
authors.affiliation: Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile. jmallol@vtr.net.
authors.forename: Javier
authors.initials: J
authors.lastname: Mallol
authors.affiliation: Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: Dirceu
authors.initials: D
authors.lastname: Solé
authors.affiliation: Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, and IMIB Research Institute, Murcia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Garcia-Marcos
authors.affiliation: Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Rosario
authors.affiliation: Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile.
authors.forename: Viviana
authors.initials: V
authors.lastname: Aguirre
authors.affiliation: Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil.
authors.forename: Herberto
authors.initials: H
authors.lastname: Chong
authors.affiliation: Pediatric Asthma Prevention Program (PIPA), Uruguaiana, Brazil.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Urrutia-Pereira
authors.affiliation: Hospital de Niños "Ricardo Gutierréz", Buenos Aires, Argentina.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Szulman
authors.affiliation: Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia.
authors.forename: Jurg
authors.initials: J
authors.lastname: Niederbacher
authors.affiliation: Section of Allergy and Clinical Immunology, British American Hospital, Lima, Peru.
authors.forename: Erika
authors.initials: E
authors.lastname: Arruda-Chavez
authors.affiliation: Hospital de Base de São José do Rio Preto, Faculty of Medicine of Sao José do Rio Preto, São Paulo, Brazil.
authors.forename: Eliana
authors.initials: E
authors.lastname: Toledo
authors.affiliation: Department of Pediatrics, Federal University of Mato Grosso, Cuiaba, Brazil.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sánchez
authors.affiliation: Clínica Pediátrica "B". Hospital Pereira Rossell, Facultad Medicina, Universidad de la Republica, Montevideo, Uruguay.
authors.forename: Catalina
authors.initials: C
authors.lastname: Pinchak
keywords: Asthma; antibiotics; epidemiology; prevalence; recurrent wheezing; respiratory sounds