Received wisdom is that there's no need to prescribe antibiotics for wheeze in young children because any underlying infection is probably viral. But Hans Bisgaard and colleagues' analysis from the Copenhagen Prospective Study on Asthma in Childhood provides evidence to the contrary (p 770). They examined around 900 throat aspirate samples from about 300 wheezing babies and toddlers and found that wheezy episodes defined-at medical examination-as audible wheeze, prolonged expiration, or ronchi on auscultation were significantly and independently associated with both viral infection and bacterial infection (mostly from H influenzae, M catarrhalis, and S pneumonia). The authors now recommend randomised clinical trials to evaluate the effectiveness of antibiotics in wheezy children.
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