Classification and pharmacological treatment of preschool wheezing: changes since 2008.

Brand, Paul L P; Caudri, Daan; Eber, Ernst; Gaillard, Erol A; Garcia-Marcos, Luis; Hedlin, Gunilla; Henderson, John; Kuehni, Claudia E; Merkus, Peter F J M; Pedersen, Soren; Valiulis, Arunas; Wennergren, Göran; Bush, Andrew (2014). Classification and pharmacological treatment of preschool wheezing: changes since 2008. European respiratory journal, 43(4), pp. 1172-7. European Respiratory Society 10.1183/09031936.00199913

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Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some modifications to the recommendations made in 2008. Specifically, the consensus group acknowledges that wheeze patterns in young children vary over time and with treatment, rendering the distinction between episodic viral wheeze and multiple-trigger wheeze unclear in many patients. Inhaled corticosteroids remain first-line treatment for multiple-trigger wheeze, but may also be considered in patients with episodic viral wheeze with frequent or severe episodes, or when the clinician suspects that interval symptoms are being under reported. Any controller therapy should be viewed as a treatment trial, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes and should be reserved for severe exacerbations in hospitalised patients. Future research should focus on better clinical and genetic markers, as well as biomarkers, of disease severity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

28 Feb 2014 09:09

Last Modified:

04 May 2015 14:22

Publisher DOI:

10.1183/09031936.00199913

PubMed ID:

24525447

BORIS DOI:

10.7892/boris.42183

URI:

https://boris.unibe.ch/id/eprint/42183

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