Introduction: Use of Inhaled Corticosteroids in Infants and Toddlers with Recurrent Wheezing

On November 1, 2010, a debate was held at the American College of Chest Physicians Meeting in Vancouver, British Columbia, Canada. Dr. Nemr Eid presented arguments in favor of using inhaled corticosteroids in infants and toddlers with recurrent wheezing. Dr. Jeremy Hull spoke against this practice.

In the United States, inhaled corticosteroids are frequently used in this patient population. In the United Kingdom, the converse is true. There is much controversy as to the efficacy of this pharmacologic intervention. Some physicians feel that therapy can result in a reduction of severity and frequency of wheezing illnesses. Others argue that the evidence for this benefit is limited. Furthermore the significant side effects, including altered growth velocity, may outweigh the purported benefits.

Dr. Eid has published extensively on pulmonary function in wheezy infants. He is a professor of pediatrics at the University of Kentucky at Louisville in the United States. Dr. Hull is the lead author of a textbook on pediatric pulmonology, a consultant in pediatric respiratory medicine at Oxford Children's Hospital, and a faculty member of Oxford University School of Medicine in the United Kingdom. This author was privileged to serve as a moderator of this debate.

The following is a summary of their respective presentations.