Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report

Bacharier, Leonard B.; Al, Boner; Carlsen, Kai‐Håkon; Eigenmann, Philippe; Frischer, Thomas; Götz, M.; Helms, Peter Joseph Benedict; Hunt, J.F.; Liu, A.; Papadopoulos, Nikolaos G.; Platts-Mills, Thomas A.E.; Pohunek, Petr; Simons, F. E. R.; Valovirta, Erkka; Wahn, Ulrich; Wildhaber, Johannes H.

doi:10.1111/j.1398-9995.2007.01586.x

Cited by 506 publications

(458 citation statements)

References 291 publications

(345 reference statements)

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“…Asthma was considered according to consensus definitions. 12 IgE-mediated food allergy was established on the basis of standardised criteria. 13 Reactions were classified as immediate reactions, which occurred within one hour after antibiotic administration, or nonimmediate reactions, which became apparent one hour after the antibiotic exposure.…”

Section: Data Collectionmentioning

confidence: 99%

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

Chambel

Martins

Silva

et al. 2010

Allergologia et Immunopathologia

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Background: Few studies have been performed in children with suspected betalactam allergy. We aimed to assess the role of the drug provocation test (DPT) with betalactams in a paediatric setting and to study the association between allergy to betalactam antibiotics and other allergic diseases. Methods: We included all the patients under 15 years old who were consecutively referred to the Immunoallergy Department, Dona Estefânia Hospital, Portugal (January 2002 to April 2008) for a compatible history of allergic reaction to betalactam. All were submitted to a DPT. Children were proposed to perform skin tests (ST) to betalactam antibiotics followed by DPT. If they decline ST, a DPT with the culprit drug was performed. Results: We studied 161 children, 60% were boys, with a median age of 5 years old at the time of the DPT. Thirty-three patients (20.5%) had an immediate reaction and 33 (20.5%) a non-immediate reaction. The severity of the reported reactions was low in most cases. Skin tests to betalactams were performed in 47 children and were positive in 8. DPT was positive in only one (3.4%) of the patients skin tested and in 11 (13.4%) of those not skin tested. The severity of the DPT reaction was low. Asthma and food allergy were associated with a positive DPT in the later group. Conclusions: DPT seems a safe procedure even in the absence of ST in non-severe cases. This could be a practical option in infants and pre-school children, where ST are painful and difficult to perform. Additional caution should be taken in children with asthma and food allergy.

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Section: Data Collectionmentioning

confidence: 99%

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

Chambel

Martins

Silva

et al. 2010

Allergologia et Immunopathologia

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“…Under-diagnosis of childhood asthma and subsequent inadequate control of the disease is an important clinical and public health issue [13,14]. The presented findings suggest that in the study area the level of under-diagnosis of the disease approaches 20%.…”

Section: Discussionmentioning

confidence: 77%

“…Allergic presentation and seasonality of the symptoms become more evident and the severity of the disease is more visible in school children, compared with younger age groups. As a result, diagnosis of asthma is usually possible through longterm follow up and a careful time-consuming differential diagnosis [13]. This phenomenon is also described regarding adult asthma -the diagnosis of asthma is often overlooked in patients with a mild form of the disease [18].…”

Section: Discussionmentioning

confidence: 99%

Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland

Zejda

Farnik

Smółka

et al. 2017

Ann Agric Environ Med.

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Introduction. The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past. Materials and method. The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI). Results. Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child -OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years -logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km -logOR = 3.45 (95%CI: 1.05-11.36), time spent with child < 1 hour/day -logOR = 6.28 (95%CI: 1.98-19.91). Conclusion. Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

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“…If treatment is started with IC, but there is no beneficial effect whatsoever, clinical guidelines recommend that they should be withdrawn. 4 Despite all of the knowledge that has been accumulated about wheezing in infants, there is no standardized instrument for determining its prevalence, clinical characteristics or risk factors or for investigating how our population's wheezing infants are cared for.…”

Section: Introductionmentioning

confidence: 99%

“…This difficulty with diagnosing asthma, combined with a lack of standardized instruments to determine its prevalence in infants and preschool children means there is a lack of data on the disease among young children. 4 Many children exhibit symptoms of bronchial obstruction before they are 5, especially wheezing and coughing. The results of cohort studies show a great deal of variation and indicate that between 10 and 80.3% of infants suffer at least one episode of wheezing during their first year of life, while 8 to 43.1% have three or more episodes, with lower prevalence rates in developed countries.…”

Section: Introductionmentioning

confidence: 99%

Sibilância no lactente: epidemiologia, investigação e tratamento

Neto¹

2010

J. Pediatr. (Rio J.)

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Objective: To perform a review of the epidemiological aspects of investigating and treating wheezing in infants.Sources: A search was run on MEDLINE using the keywords "wheezing," "infants," "diagnosis," "treatment," and "children," and Google was also used to search for "Estudio Internacional de Sibilancias en Lactantes." Summary of the findings:The prevalence of wheezing in infants varies greatly around the world. The factors associated with wheezing in infants are different at different research centers. Treatment of wheezing infants is still controversial and is dependent on a precise diagnosis. Clinical history and physical examination are fundamental to diagnosis. Conclusions:A standardized method could reveal data of relevance to the epidemiology and treatment of wheezing in Brazil and allow comparisons between different participating centers.

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Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report

Cited by 506 publications

References 291 publications

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland

Sibilância no lactente: epidemiologia, investigação e tratamento

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