Wheezing and respiratory infections in Brazilian children: does a standard management work?

ABSTRACT

BACKGROUND: Wheezing associated with acute respiratory infections (ARI) is responsible for unnecessary use of antibiotics. OBJECTIVES: To evaluate the response of children with ARI and wheezing managed according to the World Health Organization (WHO) protocol. METHODS: Cross-sectional study of children aged 2-59 months conducted in a Brazilian pediatric public hospital. Children showing fast breathing received inhalations of bronchodilator. Those who persisted with fast breathing had chest radiographs taken. When appropriate, oral antibiotics were prescribed for pneumonia. Audible wheezing was also registered. RESULTS: We included 217 children mean age 25.7 months (SD = 17.5) with 54.4% (118/217) being males. Audible wheezing was detected in 18.6% (40/217). In 87.6% (190/217) of children normal respiratory rates were reached after inhalations. In cases of pneumonia, 26% (7/27) persisted with fast breathing. CONCLUSION: A good response using WHO protocol suggests its usefulness in emergency rooms, although few cases will continue to receive antibiotics unnecessarily.