3029 Asthma Treatment May Be Useful to Treat Recurrent Wheezing In Infancy

Tuesday, 6 December 2011
Poster Hall (Cancún Center)

Herberto Jose Chong Neto, MD, PhD , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Nelson Rosario, MD, PhD , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Flávia Carnieli Silva , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Emanuel Antonio Grasselli , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Lylia Fátima Melniski Bojarski , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Cristine Secco Rosario , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Bernardo Augusto Rosario , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Fernando Henrique Chong , Allergy and Immunology, Federal University of Paraná, Curitiba, Brazil

Background: There are controversies in treating recurrent wheezing (≥3 episodes) in pre-school children. The aim of this study was to verify changes in treatment of recurrent wheezing infants. 

Methods: Cross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) that covers physician diagnosis of asthma, and frequency, severity, and treatment of wheezing episodes. Regarding treatment specific questions are: Has your baby been treated with inhaled short-acting β2-agonists by metered dose inhaler or nebulizer? Has your baby been treated with inhaled corticosteroids? Has your baby been treated with antileukotrienes? Has your baby been treated with oral corticosteroids? Parents of infants, ages 12-15 months that attended to Health Centers for routine immunization were interviewed between August/2005 to December/2006 (EISL Phase I) and September/2009 to September/2010 (EISL Phase III). Categorical variables are showed as proportion and differences verified by chi-square test. 

Results: Three thousand and three parents of infants answered questionnaire in the EISL Phase I and 22.6% had recurrent wheezing episodes. Five years later, in the EISL Phase III, one thousand and three parents participated in the survey and 19.8% had recurrent wheezing (p=0.1). Inhaled short-acting β2-agonists continued to be prescribed in the same frequency (89.6% vs 86.5%, p=0.21), however anti-asthmatic drugs were more used [antileukotrienes (6.9% vs 33%, p<0.001), inhaled steroids (23.6% vs 37.5%, p=0.001) and oral steroids (18.6% vs 26.5%, p=0.01)] and doctor diagnosis of asthma has increased (16.2% vs 23%, p=0.03). There were reductions on night-time symptoms (73% vs 61.5%, p=0.001), severity (59.3% vs 42%, p=0.001) and emergency room visits (69.3% vs 41.5%, p<0.001) for recurrent wheezing infants, but no difference was seen in hospitalization (17.1% vs 12.5%, p=0.12).

Conclusions: Recurrent wheezing treatment in infancy has increased in past years and may have contributed for reducing emergency room visits, night-time symptoms and severity for wheezing infants.