Medicines used in respiratory diseases only seen in children

Abstract

Detailed literature searches were carried out in seven respiratory disease areas. Therapeutic evidence for efficacy of medicinal products was assessed using the Grades of Recommendation, Assessment and Evaluation (GRADE) methodology, as well as an assessment of safety and side-effects.Systemic corticosteroids may reduce the development of bronchopulmonary dysplasia but have serious side-effects. Antioxidants need further study to demonstrate whether they have long-term benefits. Treatments for acute bronchiolitis have shown little benefit but new antiviral and monoclonal antibodies need further assessment. Well-constructed studies are needed to confirm the value of inhaled corticosteroids and/or montelukast in the management of viralinduced wheeze. Corticosteroids are the treatment of choice in croup. Minimal or no information is available for the treatment of congenital lung abnormalities, bronchiolitis obliterans and interstitial lung disease.

What the pulmonary specialist should know about the new inhalation therapies

“…However, many of the paediatric indications are not evidence-based. A recent ERS Task Force guideline discusses recommended treatments for paediatric pulmonary diseases [112].…”

Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment

“…A score of >7 points indicated a diagnosis of BO, with a specificity of 100% and a sensitivity of 67%. PIBO is a rare disease, which has limited the opportunity for proper randomized clinical trials focused on its treatment; thus, therapeutic decisions are empirically based (23,24). The drug treatments for PIBO include: i) Oral or inhaled corticosteroids aimed at reducing the inflammatory component; ii) hydroxychloroquine and high-dose pulses of methylprednisolone for treating severe or prolonged obstruction; iii) short and long-acting bronchodilators or inhaled anticholinergic agents for cases of symptomatic wheezing; and iv) antibiotics, orally or intravenously administered, for the treatment of patients with frequent infections (25).…”

Inhaled Therapy in Children

“…Yine son zamanlarda steroidlerden siklesonidin (Alvesco ® ) solunum yolu hücre duvarındaki lipidlerle konjugasyona gitmesi nedeniyle günde tek doz uygulaması gündeme gelmiştir. 43,44 Non-steroid antiinflamatuarlar (Kromonlar): Etkisinin görü-lebilmesi için en az 2 haftalık süreye ihtiyaç vardır; maksimum etki 4-6 haftada ortaya çıkar. Etkisini mast hücre duvarını stabilize ederek, eozinofil ve epitel hücrelerin aktivasyonunu engelleyerek gösterir.…”