Management of acute respiratory diseases in the pediatric population: the role of oral corticosteroids.
Respiratory diseases account for about 25% of all pediatric consultations, and 10% of these are for asthma. The other main pediatric respiratory diseases, in terms of incidence, are bronchiolitis, acute bronchitis and respiratory infections. Oral corticosteroids, in particular prednisolone, are often used to treat acute respiratory diseases given their anti-inflammatory effects. However, the efficacy of treatment with oral corticosteroids differs among the various types of pediatric respiratory diseases. Notably, also the adverse effects of corticosteroid treatment can differ depending on dosage, duration of treatment and type of corticosteroid administered - a case in point being growth retardation in long-course treatment. A large body of data has accumulated on this topic. In this article, we have reviewed the data and guidelines related to the role of oral corticosteroids in the treatment and management of pediatric bronchiolitis, wheezing, asthma and croup in the attempt to provide guidance for physicians. Also included is a section on the management of acute respiratory failure in children.
Pediatric Pulmonology and Sleep & Long Term Ventilation Unit, Academic Department Pediatric Hospital "Bambino Gesù", Piazza S. Onofrio 4, 00165, Rome, Italy. renato.cutrera@opbg.net.
Renato
R
Cutrera
Women's and Children's Health Department, University of Padua, Via Giustiniani 3, 35128, Padova, Italy.
Eugenio
E
Baraldi
Department of Maternal and Child Care and Urology, Gender Medicine Polyclinic, University of Rome "Sapienza", Piazzale Aldo Moro 5, 00185, Rome, Italy.
Luciana
L
Indinnimeo
Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Via Luigi De Crecchio 4, 80138, Naples, Italy.
Michele
M
Miraglia Del Giudice
Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
Giorgio
G
Piacentini
Department of Oncology and Onco-Hematology, University of Milan, Via Vanvitelli 32, 20129, Milan, Italy.
Francesco
F
Scaglione
Pediatric Pulmonology and Sleep & Long Term Ventilation Unit, Academic Department Pediatric Hospital "Bambino Gesù", Piazza S. Onofrio 4, 00165, Rome, Italy.
Nicola
N
Ullmann
Women's and Children's Health Department, University of Padua, Via Giustiniani 3, 35128, Padova, Italy.
Laura
L
Moschino
Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Via Luigi De Crecchio 4, 80138, Naples, Italy.
Francesca
F
Galdo
Department of Maternal and Child Care and Urology, Gender Medicine Polyclinic, University of Rome "Sapienza", Piazzale Aldo Moro 5, 00185, Rome, Italy.
Marzia
M
Duse
D000208:Acute Disease; D000284:Administration, Oral; D001249:Asthma / Q000188:drug therapy; D001988:Bronchiolitis / Q000188:drug therapy; D002648:Child; D003440:Croup / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D012135:Respiratory Sounds / Q000187:drug effects; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D005938:Glucocorticoids
Acute respiratory diseases; Asthma; Bronchiolitis; Croup; Respiratory failure; Wheezing