Objective

To summarize the recent evidence in the treatment of viral-induced wheezing in the infant and preschool aged child.

Data Sources

Published literature obtained through PubMed database searches.

Study Selections

Studies relevant to phenotypes and treatment of wheezing illnesses in infants and preschool children were included.

Results

Recurrent wheezing in preschool children is common and is frequently triggered by viral respiratory tract infections. Certain phenotypes may respond to treatments differently, depending on the risk factors identified. Inhaled corticosteroids, administered continuously or intermittently, reduce the risk of virus-induced wheezing episodes. The use of leukotriene modifying agents may have a role in wheezing episodes in a select group of preschool children. Early administration of azithromycin reduces the risk of severe lower respiratory tract illnesses in children. The effect of oral corticosteroids on wheezing episodes in young children varies by degree of episode severity.

Conclusion

Recurrent viral-induced wheezing illnesses has been the focus of many clinical trials, which now provide an increasingly robust evidence base for management. Additional research is needed to define optimal strategies, to best match therapies to specific phenotypes and endotypes, and will eventually begin to include therapies directed specifically at the viral triggers.

中文翻译：

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预防和治疗学龄前儿童反复发作的病毒性喘息。

目的

总结最近在婴儿和学龄前儿童中治疗病毒性喘息的证据。

数据源

通过PubMed数据库搜索获得的出版文献。

研究选择

涉及与表型和婴儿和学龄前儿童喘息病的治疗有关的研究。

结果

学龄前儿童经常出现喘息，这通常是由病毒性呼吸道感染引起的。某些表型可能会根据确定的风险因素对治疗产生不同的反应。连续或间断吸入皮质类固醇激素可降低病毒引起的喘息发作的风险。在选择的一组学龄前儿童中，白三烯修饰剂的使用可能在喘息发作中起作用。早期给予阿奇霉素可降低儿童患严重下呼吸道疾病的风险。口服皮质类固醇对幼儿喘息发作的影响因发作严重程度而异。

结论

复发性病毒引起的喘息性疾病一直是许多临床试验的重点，这些试验现在为管理提供了越来越强大的证据基础。需要进一步的研究来确定最佳策略，以使疗法与特定表型和内型最匹配，最终将开始包括针对病毒触发因素的疗法。