Some clinical considerations on infants with recurrent respiratory symptoms

Abstract

The different Guidelines on asthma treatment most commonly used do not adequately recognize the specificity and heterogeneity of infant asthma. Many infants have recurrent episodes of respiratory difficulty, with different mixed symptoms, among them whistling rales, but only some continue to have clinical manifestations of asthma after the first years of life. The Guidelines usually establish common treatment recommendations for infants and pre-school children. This is not correct. The clinical reality indicates that infants should be contemplated independently. Treatment of infant asthma in accordance with that advised in the Guidelines has not led to a decrease in hospital admissions for asthma in this age group. There are signs that the predominant pathogenic substrate in infant asthma does not consist, on the contrary to that which occurs in older ages, in an eosinophilic inflammation. Consequently, it is very questionable that inhaled glucocorticoids should be the treatment of choice in infant asthma.