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Oral and inhaled corticoid treatment for wheezing in the first year of life

OBJECTIVE: To evaluate the prevalence of corticoid utilization for the treatment of wheezing in infants less than 12 months old and to analyze factors associated with this practice. METHODS: This was a cross-sectional study that administered the validated questionnaire from the International Study on the Prevalence of Wheezing in Infants to 1,261 infants aged 12 to 15 months in Belo Horizonte, Brazil. Proportions and 95% confidence intervals were calculated and the chi-square test was used to detect associations between variables. RESULTS: Six hundred and fifty-six (52%) infants, 53% male and 48.2% white, exhibited wheezing during the first year of life. Mean age at first episode was 5.11±2.89 months. There was a high rate of morbidity, with many emergency visits (71%) and hospitalizations (27.8%). Also common were a family history of asthma and atopic disease (32.2 to 71%) and exposure to passive smoking (41.5%) and to mould (47.3%). The prevalence rates for corticoid use, whether via oral route (48.7%) or inhaled (51.3%), were elevated and were higher in the group that suffered three or more episodes. Children suffering greater morbidity were more likely to be prescribed a corticoid (p < 0.05). CONCLUSION: The high frequency of corticoid use highlights the need to establish specific criteria for the treatment of wheezing in the first years of life in order to avoid extrapolation of asthma treatments to other conditions that are transitory and self-limiting and in which using corticoids could involve more risk than benefit.

Infant; asthma; treatment; morbidity


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