Treating Childhood Wheeze Periodically Proves Effective

Respiratory tract infection requires daily treatments for wheezing

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Parents whose children have frequent wheezing may now have several treatment options available to them. At the first sign of a respiratory tract infection, periodic medication was just as effective as daily treatments for wheezing.

Researchers discovered that at the earliest sign of a respiratory tract infection, periodic doses of inhaled steroids were just as effective as daily treatment in preventing bouts of wheezing and decreasing symptoms. Periodic treatment and daily treatments had similar benefits to quality of life, decrease in school absences and reduction of the severity of respiratory tract infections. This can give doctors more tools to help treat childhood wheeze.

"Take your child to a doctor at the first sign of a respiratory tract infection."

The research, led by the Washington University School of Medicine in St. Louis, examined 300 children aged from 12 months to four years old who had frequent wheezing for one year. These children were at an increased risk of developing asthma as well.

The goal of the study was to understand what methods were effective in treating children to lessen severity of respiratory tract infection symptoms, said Leonard B. Bacharier, MD, a Washington University pediatric asthma and allergy specialist at St. Louis Children’s Hospital. According to Dr. Bacharier, despite frequent wheezing, most symptoms were only seen in children during colds and respiratory infections.

Aside from frequent bouts of wheezing, the children were at a higher risk for worsening symptoms that could require oral steroidal treatments or possible hospitalization. One group of children were given Pulmicort (budesonide) as a daily treatment. Another group was given a placebo until they showed the first signs of a respiratory tract infection. The placebo was then replaced with a a higher dose of Pulmicort twice a day.

Parents recorded daily wheezing, coughing, and breathing difficulty habits that may have impaired normal activity. Any doctor visits or school absences were also noted. Both groups had similar results in regards to the number of days with symptoms, use of medication and time before symptoms worsened and needed oral steroid treatment.

For parents who were worried about the impact of daily treatment affecting a child's normal development and growth, these results give parents an alternative method of treatment. Dr. Bacharier still recommends daily treatment for children with frequent wheezing but recognizes that a higher-dose treatment during the first signs of respiratory tract infection is just as effective.

For children whose symptoms are not usually evident before a respiratory tract infection, parents should still err on the side of caution, but there is now a choice. Whether it is a daily treatment or treatment at the earliest sign of a cold, children with frequent wheezing now have several options that can help them live a more normal life. 

This study was published in the November edition of The New England Journal of Medicine.

Reviewed by: 
Review Date: 
November 30, 2011
Last Updated:
December 4, 2011