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Infantile wheeze: rethinking dogma
  1. Fernando Maria de Benedictis1,
  2. Andrew Bush2,3
  1. 1Salesi Children's Hospital Foundation, Ancona, Italy
  2. 2Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
  3. 3National Heart and Lung Institute, Imperial School of Medicine, London, UK
  1. Correspondence to Dr Fernando Maria de Benedictis, Salesi Children's Hospital Foundation, 11, via Corridoni, Ancona I-60123, Italy; pediatria{at}


Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy. Good multidisciplinary support, attention to environmental exposition and education are essential in managing this common condition. This article analyses the pathophysiological basis of wheezing in infancy and critically discusses the evolution of the scientific progress over time in this unique field of respiratory medicine.

  • wheezing
  • infants
  • preschool children

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  • Contributors FMdB wrote the initial draft of the manuscript. Both authors participated in the critical revision for intellectual content and accepted the final version of the manuscript.

  • Funding AB was supported by the NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.