NEW YORK (Reuters Health) Oct 09 - The most effective way to manage frequent wheezing in preschool children is regular treatment with nebulized glucocorticoids, according to a report in the October issue of Allergy.
The authors of the report also suggest that as-needed use of a bronchodilator and glucocorticoid combination, which is commonly practiced, may be an alternative.
Dr. Leonardo M. Fabbri, of the University of Modena and Reggio Emilia, Italy, and colleagues conducted a trial in which 276 children ages 1 to 4 years with frequent wheeze were randomized to nebulized treatment with one of three regimens for 12 weeks: 400 mcg beclomethasone twice daily plus 2500 mcg salbutamol as needed; placebo plus a combination of 800 mcg beclomethasone/1600 mcg salbutamol as needed, or placebo plus 2500 mcg salbutamol as needed.
The primary outcome measure -- percentage of symptom-free days -- was significantly higher with daily beclomethasone (69.6%) compared with as-needed salbutamol (61.0%; p = 0.034).
Regular treatment with nebulized beclomethasone also improved several secondary outcomes, including nocturnal wakening and exacerbations.
There was no difference in percentage of symptom-free days between children with or without risk factors for asthma.