AUTHOR=O’Grady Kerry-Ann F , Grimwood Keith 

TITLE=The Likelihood of Preventing Respiratory Exacerbations in Children and Adolescents with either Chronic Suppurative Lung Disease or Bronchiectasis

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 5 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2017.00058

DOI=10.3389/fped.2017.00058

ISSN=2296-2360

ABSTRACT=Chronic suppurative lung disease (CSLD) and bronchiectasis in children and adolescents are important causes of respiratory morbidity and reduced quality of life (QoL), while also leading to subsequent premature death during adulthood. Acute respiratory exacerbations in pediatric CSLD and bronchiectasis are important markers of disease control clinically given they impact upon QoL, increase healthcare-associated costs, and can adversely affect future lung function. Preventing exacerbations in this population are therefore likely to have significant individual, familial, societal and health sector benefits. In this review we focus on therapeutic interventions, such as drugs (antibiotics, mucolytics and hyperosmolar agents, bronchodilators, corticosteroids, non-steroidal anti-inflammatory agents), vaccines and physiotherapy, care-planning, such as post-hospitalization management and health promotion strategies, including exercise, diet and reducing exposure to environmental toxicants. The review identified a conspicuous lack of moderate or high-quality evidence for preventing respiratory exacerbations in children and adolescents with CSLD or bronchiectasis. Given the short- and long-term impact of exacerbations upon individuals, their families and society as a whole, large studies addressing interventions at the primary and tertiary prevention phases are required. This research must include children and adolescents in both developing and developed countries and address long-term health outcomes.