Purpose of review: The high prevalence of wheezing illnesses in the preschool age group and the heterogeneity of wheezing phenotypes early in life combine to present significant challenges in the clinical management of this problem.
Recent findings: Recent studies have examined multiple therapeutic strategies to reduce the frequency and/or severity of viral-triggered wheezing episodes in young children. Clinical trials demonstrate various degrees of clinical benefit associated with daily use of inhaled corticosteroids or leukotriene receptor antagonists in terms of episode prevention and attenuation, and with episodic therapy with high-dose inhaled corticosteroids or leukotriene receptor antagonists in terms of episode attenuation. Recent evidence has brought into question the efficacy of systemic corticosteroid therapy as an element of inpatient care for viral-induced wheezing.
Summary: The optimal management strategy for virus-induced wheezing in early life remains elusive. Future research in this area should incorporate consideration of the heterogeneous nature of this complex syndrome.