The wheezy child from birth to three years, a therapeutic approach.

The population of wheezy children aged zero to three years is heterogeneous and includes cases of bronchiolitis and infantile asthma. Bronchiolitis is essentially treated by respiratory physiotherapy. The ongoing treatment of infantile asthma is essentially based on inhaled corticosteroid therapy (IC) at minimal effective doses. The use of IC was justified by recent data demonstrating the presence of early bronchial inflammation in all these children, whether or not they have a risk factor (family and/or personal history of atopy). Children who spontaneously progress towards a regression of symptoms also show clinical improvement on IC. Progression towards persistent symptoms is difficult to predict. IC treatment may limit remodelling and preserve respiratory function. (C) 2002 Editions scientifiques et medicales Elsevier SAS.