Top

Published in:

Open Access 01-12-2021 | Review

Prevention of recurrent respiratory infections

Inter-society Consensus

Authors: Elena Chiappini, Francesca Santamaria, Gian Luigi Marseglia, Paola Marchisio, Luisa Galli, Renato Cutrera, Maurizio de Martino, Sara Antonini, Paolo Becherucci, Paolo Biasci, Barbara Bortone, Sergio Bottero, Valeria Caldarelli, Fabio Cardinale, Guido Castelli Gattinara, Martina Ciarcià, Daniele Ciofi, Sofia D’Elios, Giuseppe Di Mauro, Mattia Doria, Luciana Indinnimeo, Andrea Lo Vecchio, Francesco Macrì, Roberto Mattina, Vito Leonardo Miniello, Michele Miraglia del Giudice, Guido Morbin, Marco Antonio Motisi, Andrea Novelli, Anna Teresa Palamara, Maria Laura Panatta, Angela Pasinato, Diego Peroni, Katia Perruccio, Giorgio Piacentini, Massimo Pifferi, Lorenzo Pignataro, Emanuela Sitzia, Chiara Tersigni, Sara Torretta, Irene Trambusti, Giulia Trippella, Diletta Valentini, Sandro Valentini, Attilio Varricchio, Maria Carmen Verga, Claudio Vicini, Marco Zecca, Alberto Villani

Published in: Italian Journal of Pediatrics | Issue 1/2021

Abstract

Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs.

Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs.

Available only for authorised users

de Martino M, Ballotti S. The child with recurrent respiratory infections: normal or not? Pediatr Allergy Immunol. 2007;18(Suppl 18):13–8. https://doi.org/10.1111/j.1399-3038.2007.00625.x.CrossRefPubMed

Toivonen L, Karppinen S, Schuez-Havupalo L, Teros-Jaakkola T, Vuononvirta J, Mertsola J, et al. Burden of recurrent respiratory tract infections in children: a prospective cohort study. Pediatr Infect Dis J. 2016;35(12):e362–9. https://doi.org/10.1097/INF.0000000000001304.CrossRefPubMed

De Benedictis FM, Bush A. Recurrent lower respiratory tract infections in children. BMJ. 2018;362:k2698. https://doi.org/10.1136/bmj.k2698.CrossRefPubMed

Brook I. Dynamics of nasopharyngitis in children. Otolaryngol Head Neck Surg. 2000;122(5):696–700. https://doi.org/10.1016/S0194-5998(00)70199-9.CrossRefPubMed

Steele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989;160(1):83–94. https://doi.org/10.1093/infdis/160.1.83.CrossRef

Ugazio AG, Cavagni G. Il bambino con infezioni ricorrenti. Masson: Milano; 2003. p. 27–251. 9788821426247

Jeffrey Modell Foundation. 10 Warning Signs of Primary Immunodeficiency for Adults. Available at tje website: http://www.info4pi.org/aboutPI/pdf/Adult10WarningSigns-FINAL.pdf. Last accessed 1 Oct 2021.

Soler-Palacín P, de Gracia J, González-Granado LI, Martín C, Rodríguez-Gallego C, Sánchez-Ramón S. Lung ID-signal group. Primary immunodeficiency diseases in lung disease: warning signs, diagnosis and management. Respir Res. 2018;19(1):219. https://doi.org/10.1186/s12931-018-0923-8.CrossRefPubMedPubMedCentral

Montella S, Corcione A, Santamaria F. Recurrent pneumonia in children: a reasoned diagnostic approach and a single Centre experience. Int J Mol Sci. 2017;18(2):296. https://doi.org/10.3390/ijms18020296.CrossRefPubMedCentral

10.

Zuccotti GV, Mameli C, Trabattoni D, Beretta S, Biasin M, Guazzarotti L, et al. Immunomodulating activity of Pidotimod in children with Down syndrome. J Biol Regul Homeost Agents. 2013;27(1):253–8.PubMed

11.

Masihi KN. Immunomodulators in infectious diseases: panoply of possibilites. Int J Immunopharmacol. 2000;22(12):1083–91. https://doi.org/10.1016/S0192-0561(00)00074-6.CrossRefPubMed

12.

Mailland F, Coppi G, Silingardi S. Pharmacokinetics and oral bioavailability of pidotimod in humans. Arzneimittelforschung. 1994;44(12A):1465–9.PubMed

13.

D'Angelo L, De Ponti F, Crema F, Caravaggi M, Crema A. Effect of food on the bioavailability of pidotimod in healthy volunteers. Arzneimittelforschung. 1994;44(12A):1473–5.PubMed

14.

Esposito S, Garziano M, Rainone V, Trabattoni D, Biasin M, Senatore L, et al. Immunomodulatory activity of pidotimod administered with standard antibiotic therapy in children hospitalized for community-acquired pneumonia. J Transl Med. 2015;13(1):288. https://doi.org/10.1186/s12967-015-0649-z.CrossRefPubMedPubMedCentral

15.

Bozzetto S, Pirillo P, Carraro S, Berardi M, Cesca L, Stocchero M, et al. Metabolomic profile of children with recurrent respiratory infections. Pharmacol Res. 2017;115:162–7. https://doi.org/10.1016/j.phrs.2016.11.007.CrossRefPubMed

16.

Santamaria F, Montella S, Stocchero M, Pirillo P, Bozzetto S, Giordano G, et al. Effects of pidotimod and bifidobacteria mixture on clinical symptoms and urinary metabolomic profile of children with recurrent respiratory infections: a randomized placebo-controlled trial. Pulm Pharmacol Ther. 2019;58:101818. https://doi.org/10.1016/j.pupt.2019.101818.CrossRefPubMed

17.

Licari A, De Amici M, Nigrisoli S, et al. Pidotimod may prevent recurrent respiratory infections in children. Minerva Pediatr. 2014;66(5):363–7.PubMed

18.

Namazova-Baranova LS, Alekseeva AA, Kharit SM, Kozhevnikova TN, Taranushenko TE, Tuzankina IA, et al. Efficacy and safety of pidotimod in the prevention of recurrent respiratory infections in children: a multicentre study. Int J Immunopathol Pharmacol. 2014;27(3):413–9. https://doi.org/10.1177/039463201402700311.CrossRefPubMed

19.

Walavalkar KC, Joshi M, Kelkar M, Kulkarni S, Tuteja V, Scarci F. Efficacy and safety of pidotimod as adjuvant in the treatment of recurrent upper respiratory tract infections (URTI) in children. Trends Med. 2014;14:11–6 Available on: https://www.oatext.com/pdf/TiM-14-470.pdf.

20.

Das D, Narayanan V, Rathod R, Barkate HV, Sobti V. Efficacy of Pidotimod in reducing recurrent respiratory tract infections in Indian children. New Indian J Paediatr. 2017;6:101–10 Available on: https://nijp.org/efficacy-of-pidotimod-in-reducing-recurrent-respiratory-tract-infections-in-indian-children/.

21.

Esposito S, Soto-Martinez ME, Feleszko W, Jones MH, Shen KL, Schaad UB. Nonspecific immunomodulators for recurrent respiratory tract infections, wheezing and asthma in children: a systematic review of mechanistic and clinical evidence. Curr Opin Allergy Clin Immunol. 2018;18(3):198–209. https://doi.org/10.1097/ACI.0000000000000433.CrossRefPubMedPubMedCentral

22.

Niu H, Wang R, Jia YT, Cai Y. Pidotimod, an immunostimulant in pediatric recurrent respiratory tract infections: a meta-analysis of randomized controlled trials. Int Immunopharmacol. 2019;67:35–45. https://doi.org/10.1016/j.intimp.2018.11.043.CrossRefPubMed

23.

Esposito S, Jones MH, Feleszko W, Martell JAO, Falup-Pecurariu O, Geppe N, et al. Prevention of new respiratory episodes in children with recurrent respiratory infections: an expert consensus statement. Microorganisms. 2020;8(11):1810. https://doi.org/10.3390/microorganisms8111810.CrossRefPubMedCentral

24.

Agenzia Italiana del Farmaco (AIFA). Pidotimod. Available at he website: https://farmaci.agenziafarmaco.gov.it/bancadatifarmaci/cerca-per-principio-attivo?princ_att=Pidotimod. Last accessed 1 Oct 2021.

25.

Cantarini L, Brogna A, Fioravanti A, Galeazzi M. Henoch-Schönlein purpura associated with pidotimod therapy. Clin Exp Rheumatol. 2008;26:S152.PubMed

26.

Zuccotti GV, Mameli C. Pidotimod: the past and the present. Ital J Pediatr. 2013;39(1):75. https://doi.org/10.1186/1824-7288-39-75.CrossRefPubMedPubMedCentral

27.

Miniello VL, Diaferio L, Cristofori F, et al. Gut microbiota biomodulators, when the stork comes by the scalpel. Clin Chim Acta. 2015;451:88–96. https://doi.org/10.1016/j.cca.2015.01.022.CrossRefPubMed

28.

Mennini M, Dahdah L, Artesani MC, Fiocchi A, Martelli A. Probiotics in asthma and allergy prevention. Front Pediatr. 2017;5:165. https://doi.org/10.3389/fped.2017.00165.CrossRefPubMedPubMedCentral

29.

Miniello VL, Brunetti L, Tesse R, Natile M, Armenio L, Francavilla R. Lactobacillus reuteri modulates cytokines production in exhaled breath condensate of children with atopic dermatitis. J Pediatr Gastroenterol Nutr. 2010;50(5):573–6. https://doi.org/10.1097/MPG.0b013e3181bb343f.CrossRefPubMed

30.

Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, et al. Expert consensus document: the international scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491–502. https://doi.org/10.1038/nrgastro.2017.75.CrossRefPubMed

31.

Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;2:CD006895. https://doi.org/10.1002/14651858.CD006895.pub3.CrossRef

32.

Bruzzese E, Raia V, Ruberto E, Scotto R, Giannattasio A, Bruzzese D, et al. Lack of efficacy of Lactobacillus GG in reducing pulmonary exacerbations and hospital admissions in children with cystic fibrosis: a randomised placebo controlled trial. J Cyst Fibros. 2018;17(3):375–82. https://doi.org/10.1016/j.jcf.2017.10.014.CrossRefPubMed

33.

Rautava S, Salminen S, Isolauri E. Specific probiotics in reducing the risk of acute infections in infancy-a randomised, double-blind, placebo-controlled study. Br J Nutr. 2009;101(11):1722–6. https://doi.org/10.1017/S0007114508116282.CrossRefPubMed

34.

Tarantino V, Savaia V, D'Agostino R, Silvestri M, Ciprandi G. Bacteriotherapy for preventing recurrent upper respiratory infections in children: a real-world experience. Otolaryngol Pol. 2018;72(3):33–8. https://doi.org/10.5604/01.3001.0012.0482.CrossRefPubMed

35.

Hatakka K, Blomgren K, Pohjavuori S, Kaijalainen T, Poussa T, Leinonen M, et al. Treatment of acute otitis media with probiotics in otitis-prone children - a double-blind, placebo-controlled randomised study. Clin Nutr. 2007;26(3):314–2. https://doi.org/10.1016/j.clnu.2007.01.003.CrossRefPubMed

36.

Nigro A, Nicastro A, Trodella R. Retrospective observational study to investigate Sinerga, a multifactorial nutritional product, and bacterial extracts in the prevention of recurrent respiratory infections in children. Int J Immunopathol Pharmacol. 2014;27(3):455–60. https://doi.org/10.1177/039463201402700318.CrossRefPubMed

37.

Jesenak M, Ciljakova M, Rennerova Z, Babusikova E, Banovcin P. Recurrent respiratory infections in children. In Marta-N-Loeches I, ed. Bronchitis. InTech 2011. Available on: http://www.intechopen.com/books/bronchitis/recurrent-respiratory-infections-in-children-definition-diagnostic-approach-treatment-and-prevention.

38.

Fiocchi A, Omboni S, Mora R, Macchi A, Nespoli L, Arrigoni S, et al. Efficacy and safety of ribosome-component immune modulator for preventing recurrent respiratory infections in socialized children. Allergy Asthma Proc. 2012;33(2):197–204. https://doi.org/10.2500/aap.2012.33.3516.CrossRefPubMed

39.

Cazzola M, Anapurapu S, Page CP. Polyvalent mechanical bacterial lysate for the prevention of recurrent respiratory infections: a meta-analysis. Pulm Pharmacol Ther. 2012;25(1):62–8. https://doi.org/10.1016/j.pupt.2011.11.002.CrossRefPubMed

40.

Esposito S, Marchisio P, Prada E, Daleno C, Porretti L, Carsetti R, et al. Impact of a mixed bacterial lysate (OM-85 BV) on the immunogenicity, safety and tolerability of inactivated influenza vaccine in children with recurrent respiratory tract infection. Vaccine. 2014;32(22):2546–52. https://doi.org/10.1016/j.vaccine.2014.03.055.CrossRefPubMed

41.

Esposito S, Bianchini S, Polinori I, Principi N. Impact of OM-85 given during two consecutive years to children with a history of recurrent respiratory tract infections: a retrospective study. Int J Environ Res Public Health. 2019;16(6):1065. https://doi.org/10.3390/ijerph16061065.CrossRefPubMedCentral

42.

Esposito S, Bianchini S, Bosis C, Coro I, Argentiero A, Principi N. A randomized, placebo-controlled, double blinded, single-Centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections. J Transl Med. 2019;17(1):284. https://doi.org/10.1186/s12967-019-2040-y.CrossRefPubMedPubMedCentral

43.

Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr. 2010;6(1):5–12. https://doi.org/10.1007/s12519-010-0001-x.CrossRefPubMed

44.

Del-Rio-Navarro BE, Espinosa-Rosales FJ, Flenady V, Sienra-Monge JJL. Cochrane review: Immunostimulants for preventing respiratory tract infection in children. Evid Based Child Health. 2012;7(2):629–717. https://doi.org/10.1002/ebch.1833.CrossRef

45.

Yin J, Xu B, Zeng X, Shen K. Broncho-Vaxom in pediatric recurrent respiratory tract infections: a systematic review and meta-analysis. Int Immunopharmacol. 2018;54:198–209. https://doi.org/10.1016/j.intimp.2017.10.032.CrossRefPubMed

46.

Available on: https://farmaci.agenziafarmaco.gov.it/bancadatifarmaci/cerca-farmaco

47.

Katova P, Katona-Apte J. The interaction between nutrition and infection. Clin Infect Dis. 2008;46(10):1582–8. https://doi.org/10.1086/587658.CrossRef

48.

Camargo CA, Ganmaa D, Frazier AL, Kirchberg FF, Stuart JJ, Kleinman K, et al. Randomized trial of Vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics. 2012;130(3):e561–7. https://doi.org/10.1542/peds.2011-3029.CrossRefPubMed

49.

Kartasurya MI, Ahmed F, Subagio HW, Rahfiludin MZ, Marks GC. Zinc combined with vitamin a reduces upper respiratory tract infection morbidity in a randomised trial in preschool children in Indonesia. Br J Nutr. 2012;108(12):2251–60. https://doi.org/10.1017/S0007114512000499.CrossRefPubMed

50.

Adhikari DD, Saibal D. Role of zinc supplementation in the outcome of repeated acute respiratory infections in Indian children: a randomized double blind placebo-controlled clinical trial. Res J Pharm Tech. 2016;9(4):457–8. https://doi.org/10.5958/0974-360X.2016.00084.6.CrossRef

51.

Ferrara P, Ianniello F, Bianchi V, Quintarelli F, Cammerata M, Quattrocchi E, et al. Beneficial therapeutic effects of vitamin C on recurrent respiratory tract infections in children: preliminary data. Minerva Pediatr (Torino). 2021;73(1):22–7. Epub 2016 Nov 17. https://doi.org/10.23736/S2724-5276.16.04621-1.CrossRef

52.

Ghosh AK, Kishore B, Shaikh I, Satyavrat V, Kumar A, Shah T, et al. Effect of oral nutritional supplementation on growth and recurrent upper respiratory tract infections in picky eating children at nutritional risk: a randomized, controlled trial. J Int Med Res. 2018;46(6):2186–201. https://doi.org/10.1177/0300060518757355.CrossRefPubMedPubMedCentral

53.

Aydın S, Aslan I, Yıldız I, Ağaçhan B, Toptaş B, Toprak S. Vitamin D levels in children with recurrent tonsillitis. J Pediatr Otorhinolaryngol. 2011;75(3):364–7. https://doi.org/10.1016/j.ijporl.2010.12.006.CrossRef

54.

Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low serum 25- Hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clin Infest Dis. 2013;57(3):392–7. https://doi.org/10.1093/cid/cit289.CrossRef

55.

Cayir A, Turan MI, Ozkan O, Cayr Y. Vitamin D levels in children diagnosed with acute otitis media. J Pak Med Assoc. 2014;64(11):1274–7.PubMed

56.

Ingham TR, Jones B, Camargo CA Jr, The Whiti Te Rā Study Group, et al. Association of Vitamin D deficiency with severity of acute respiratory infection: a case-control study in New Zealand children. Conference Paper September 2015 DOI: https://doi.org/10.13140/2.1.3250.0485.

57.

Özdemir B, Köksal BT, Karakaş NM. Serum Vitamin D Levels in children with recurrent respiratory infections and chronic cough. Indian J Pediatr 2016;83:777–782, 8, DOI: https://doi.org/10.1007/s12098-015-2010-1.

58.

Shokrollahi MR, Zahra Movahedi Z, Nia SJ, Asl HM, Heydari H, Tabatabaei A. Comparison of Zinc,Vitamin A & D serum levels between children with respiratory tract infection and healthy individuals in two iranian referral hospitals. IOSR J Dent Med Sci. 2016;15(09):64–9. https://doi.org/10.9790/0853-1509126469.CrossRef

59.

Zhang X, Ding F, Li H, Zhao W, Jing H, Yan Y, et al. Low serum levels of vitamins a, D, and E are associated with recurrent respiratory tract infections in children living in northern China: a case control study. PLoS One. 2016;11(12):e0167689. https://doi.org/10.1371/journal.pone.0167689.CrossRefPubMedPubMedCentral

60.

Isankina LI, and Skalny AV. Hair zinc levels in children with frequent acute respiratory infections. Abstract V Congress of the Russian Society for Trace Elements in Medicine (RUSTEM). Trace elements and Electrolytes, Vol 35- No 4/ 2018: p 249–54.

61.

Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database of Syst Rev. 2013;1(5):CD000980. https://doi.org/10.1002/14651858.CD000980.pub4.CrossRef

62.

Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev. 2013;(6):CD001364.

63.

Yakoob MY, Salam RA, Khan FR, Bhutta ZA. Vitamin D supplementation for preventing infections in children under five years of age. Cochrane Database Syst Rev. 2016;11(11):CD008824. https://doi.org/10.1002/14651858.CD008824.pub2.CrossRefPubMed

64.

Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, et al. Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Health Technol Assess. 2019;23(2):1–72. https://doi.org/10.3310/hta23020.CrossRefPubMedPubMedCentral

65.

Xiao L, Xing C, Yang Z, Xu S, Wang M, du H, et al. Vitamin D supplementation for the prevention of childhood acute respiratory infections: a systematic review of randomised controlled trials. Br J Nutr. 2015;114(7):1026–34. https://doi.org/10.1017/S000711451500207X.CrossRefPubMed

66.

Charan J, Goyal JP, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infections: a systematic review and meta-analysis. J Pharmacol Pharmacother. 2012;3(4):300–3. https://doi.org/10.4103/0976-500X.103685.CrossRefPubMedPubMedCentral

67.

Jolliffe DA, Griffiths CJ, Martineau AR. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies. J Steroid Biochem Mol Biol. 2013;136:321–9. https://doi.org/10.1016/j.jsbmb.2012.11.017.CrossRefPubMed

68.

Mao S, Zhang A, Huang S. Meta-analysis of Zn, cu and Fe in the hair of Chinese children with recurrent respiratory tract infection. Scand J Clin Lab Invest. 2014;74(7):561–7. https://doi.org/10.3109/00365513.2014.921323.CrossRefPubMed

69.

Camargo CA, Ingham T, Wickens K, et al. New Zealand Asthma and Allergy Cohort Study Group. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics. 2011;127(1):e180–7. https://doi.org/10.1542/peds.2010-0442.CrossRefPubMed

70.

Marchisio P, Consonni D, Baggi E, Zampiero A, Bianchini S, Terranova L, et al. Vitamin D supplementation reduces the risk of acute otitis media in otitis-prone children. Pediatr Infect Dis J. 2013 Oct;32(10):1055–60. https://doi.org/10.1097/INF.0b013e31829be0b0.CrossRefPubMed

71.

Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, et al. Vitamin D in pediatric age: consensus of the Italian pediatric society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital. J Pediatr. 2018;44(1):51. https://doi.org/10.1186/s13052-018-0488-7.CrossRef

72.

Jong MC, Buskin SL, Ilienko L, et al. Effectiveness, safety and tolerability of a complex homeopathic medicinal product in the prevention of recurrent acute upper respiratory tract infections in children: a multicenter, open, comparative, randomized, controlled clinical trial. Multidiscip Respir Med. 2016;11(1):19. https://doi.org/10.1186/s40248-016-0056-1.CrossRefPubMedPubMedCentral

73.

Steinsbekk A, Bentzen N, Fønnebø V, Lewith G. Self treatment with one of three self selected, ultramolecular homeopathic medicines for the prevention of upper respiratory tract infections in children. A double-blind randomized placebo controlled trial. Br J Clin Pharmacol. 2005;59(4):447–55. https://doi.org/10.1111/j.1365-2125.2005.02336.x.CrossRefPubMedPubMedCentral

74.

Beghi GM, Morselli-Labate AM. Does homeopathic medicine have a preventive effect on respiratory tract infections? A real life observational study. Multidiscip Respir Med. 2016;11(1):12. https://doi.org/10.1186/s40248-016-0049-0.CrossRefPubMedPubMedCentral

75.

Grimaldi-Bensouda L, Begaud B, Rossignol M, et al. Management of upper respiratory tract infections by different medical practices, including homeopathy, and consumption of antibiotics in primary care: the EPI3 cohort study in France 2007-2008. PLoS One. 2014;9(3):e89990. https://doi.org/10.1371/journal.pone.0089990.CrossRefPubMedPubMedCentral

76.

Steinsbekk A, Fønnebø V, Lewith G, Bentzen N. Homeopathic care for the prevention of upper respiratory tract infections in children: a pragmatic, randomised, controlled trial comparing individualised homeopathic care and waiting-list controls. Complement Ther Med. 2005;13(4):231–8. https://doi.org/10.1016/j.ctim.2005.06.007.CrossRefPubMed

77.

van Haselen R, Thinesse-Mallwitz M, Maidannyk V, et al. The effectiveness and safety of a homeopathic medicinal product in pediatric upper respiratory tract infections with fever: a randomized controlled trial. Glob Pediatr Health. 2016;3:2333794X16654851.PubMedPubMedCentral

78.

Minetti AM, Forti S, Tassone G, Pignataro L. Efficacy of complex herbal compound of Echinacea angustifolia (Imoviral® junior) in recurrent upper respiratory tract infections during pediatric age: preliminary results. Minerva Pediatr. 2011;63(3):177–82.PubMed

79.

Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, LindeK. Echinacea for preventing and treating the common cold. (Review). Cochrane Libr. 2014;2(2):CD000530.

80.

Song T, Hou X, Yu X, Whang Z, et al. Adjuvant treatment with Yupingfeng formula for recurrent respiratory tract infections in children: a Meta-analysis of randomized controlled trials. Phytother Res. 2016;30(7):1095–103. https://doi.org/10.1002/ptr.5628.CrossRefPubMed

81.

Mathie RT, Frye J, Fisher P. Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness. Cochrane Libr. 2015;1(1):CD001957. https://doi.org/10.1002/14651858.CD001957.pub6.CrossRef

82.

Esposito S, Marchisio P, Cavagna R, Gironi S, Bosis S, Lambertini L, et al. Effectiveness of influenza vaccination of children with recurrent respiratory tract infections in reducing respiratory-related morbidity within the households. Vaccine. 2003;21(23):3162–8. https://doi.org/10.1016/S0264-410X(03)00253-6.CrossRefPubMed

83.

Estrada J, Najera M, Pounds N, Catano G, Infante AJ. Clinical and serologic response to the 23-valent polysaccharide pneumococcal vaccine in children and teens with recurrent upper respiratory tract infections and selective antibody deficiency. Pediatr Infect Dis J. 2016;35(2):205–8. https://doi.org/10.1097/INF.0000000000000964.CrossRefPubMed

84.

Casale M, Moffa A, Sabatino L, Pace A, Oliveto G, Vitali M, et al. Hyaluronic acid: perspectives in upper aero-digestive tract. A systematic review. PLoS One. 2015;10(6):e0130637. https://doi.org/10.1371/journal.pone.0130637.CrossRefPubMedPubMedCentral

85.

Casale M, Vella P, Moffa A, Oliveto G, Sabatino L, Grimaldi V, et al. Hyaluronic acid and upper airway inflammation in pediatric population: a systematic review. Int J Pediatr Otorhinolaryngol. 2016;85:22–6. https://doi.org/10.1016/j.ijporl.2016.03.015.CrossRefPubMed

86.

Keller S, König V, Mösges S. Thermal water applications in the treatment of upper respiratory tract diseases: a systematic review and Meta-analysis. J Allergy (Cairo). 2014;2014:943824–17. https://doi.org/10.1155/2014/943824.CrossRef

87.

King D, Mitchell B, Williams CP, Spurling GKP. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;4:CD006821. https://doi.org/10.1002/14651858.CD006821.pub3.CrossRef

88.

Macchi A, Castelnuovo P, Terranova P, Digilio E. Effects of sodium hyaluronate in children with recurrent upper respiratory tract infections: results of a randomised controlled study. Int J Immunopathol Pharmacol. 2013;26(1):127–35. https://doi.org/10.1177/039463201302600112.CrossRefPubMed

89.

Varricchio A, Giuliano M, Capasso M, del Gaizo D, Ascione E, de Lucia A, et al. Salso-sulphide thermal water in the prevention of recurrent respiratory infections in children. Int J Immunopathol Pharmacol. 2013;26(4):941–52. https://doi.org/10.1177/039463201302600412.CrossRefPubMed

90.

Montella S, Cantone E, Maglione M, Iengo M, Santamaria F. Sodium hyaluronate improves quality of life and nasal endoscopy features in preschool children with upper respiratory tract infections. J Biol Regul Homeost Agents. 2016;30(1):303–8.PubMed

91.

Varricchio A, Giuliano M, Capasso M, et al. Resveratrol plus carboxymethyl-β-glucan in children with recurrent respiratory infections: a preliminary and real-life experience. Ital J Pediatr. 2014;40(1):93. https://doi.org/10.1186/s13052-014-0093-3.CrossRefPubMedPubMedCentral

92.

Jeandet P, Bessis R, Maume BF, Meunier P, Peyron D, Trollat P. Effect of enological practices on the resveratrol isomer content of wine. J Agric Food Chem. 1995;43(2):316–9. https://doi.org/10.1021/jf00050a010.CrossRef

93.

Raal A, Pokk P, Arend A, et al. Trans-resveratrol alone and hydroxystilbenes of rhubarb (Rheum rhaponticumL.) root reduce liver damage induced by chronic ethanol administration: A comparative study in mice. Phytother Res. 2009;23:525–32.CrossRef

94.

Passariello A, Di Costanzo M, Terrin G, et al. Crenotherapy modulates the expression of proinflammatory cytokines and immunoregulatory peptides in nasal secretions of children with chronic rhinosinusitis. Am J Rhinol Allergy. 2012;26(1):e15–9. https://doi.org/10.2500/ajra.2012.26.3733.CrossRefPubMed

95.

Sauni R, Uitti J, Jauhiainen M, Kreiss K, Sigsgaard T, Verbeek JH. Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma (review). Evid Based Child Health. 2013;8(3):944–1000. https://doi.org/10.1002/ebch.1914.CrossRefPubMed

96.

Calatayud FM, Calatayud B, Gallego JG, González-Martín C, Alguacil LF. Effects of Mediterranean diet in patients with recurring colds and frequent complications. Allergol Immunopathol (Madr). 2017;45(5):417–24. https://doi.org/10.1016/j.aller.2016.08.006.CrossRef

97.

Stølevik SB, Unni Cecilie Nygaard UC, Namork E, et al. Prenatal exposure to polychlorinated biphenyls and dioxins from the maternal diet may be associated with immunosuppressive effects that persist into early childhood. Food Chem Toxicol. 2013;51:165–72. https://doi.org/10.1016/j.fct.2012.09.027.CrossRefPubMed

98.

Norbäck D, Lu C, Zhang Y, Li B, Zhao Z, Huang C, et al. Common cold among pre-school children in China - associations with ambient PM10 and dampness, mould, cats, dogs, rats and cockroaches in the home environment. Environ Int. 2017;103:13–22. https://doi.org/10.1016/j.envint.2017.03.015.CrossRefPubMed

99.

Casas L, Espinosa A, Borràs-Santos A, Jacobs J, Krop E, Heederik D, et al. Domestic use of bleach and infections in children: a multicentre cross-sectional study. Occup Environ Med. 2015;72(8):602–4. https://doi.org/10.1136/oemed-2014-102701.CrossRefPubMed

100.

Simoni M, Annesi-Maesano I, Sigsgaard T, Norback D, Wieslander G, Nystad W, et al. School air quality related to dry cough, rhinitis and nasal patency in children. Eur Respir J. 2010;35(4):742–9. https://doi.org/10.1183/09031936.00016309.CrossRefPubMed

101.

Jedrychowski WA, Perera FP, Spengler JD, Mroz E, Stigter L, Flak E. Intrauterine exposure to fine particulate matter as a risk factor for increased susceptibility to acute broncho-pulmonary infections in early childhood. Int J Hyg Environ Health. 2013;216(4):395–401. https://doi.org/10.1016/j.ijheh.2012.12.014.CrossRefPubMedPubMedCentral

102.

Marseglia GL, Avanzini MA, Caimmi S, Caimmi D, Marseglia A, Valsecchi C, et al. Passive exposure to smoke results in defective interferon-γ production by adenoids in children with recurrent respiratory infections. J Interf Cytokine Res. 2009;29(8):427–32. https://doi.org/10.1089/jir.2008.0108.CrossRef

103.

Inci G, Baysal SU, Şişman AR. Exposure to environmental tobacco smoke by healthy children aged below five (preliminary study). Turk Pediatri Ars. 2018;53(1):37–44. https://doi.org/10.5152/TurkPediatriArs.2018.5963.CrossRefPubMedPubMedCentral

104.

El-Hodhod MA, Hamdy AM, Ahmed MB, Youssef SR, Aly SM. Effect of passive smoking on blood lymphocyte apoptosis in children. Eur J Clin Investig. 2011;41(4):387–92. https://doi.org/10.1111/j.1365-2362.2010.02420.x.CrossRef

105.

Alexandrino AS, Santos R, Melo C, Bastos JM. Risk factors for respiratory infections among children attending day care centres. Fam Pract. 2016;33(2):161–6. https://doi.org/10.1093/fampra/cmw002.CrossRefPubMed

106.

Hatakka K, Piirainen L, Pohjavuori S, Poussa T, Savilahti E, Korpela R. Factors associated with acute respiratory illness in day care children. Scand J Infect Dis. 2010;42(9):704–11. https://doi.org/10.3109/00365548.2010.483476.CrossRefPubMed

Title: Prevention of recurrent respiratory infections
Inter-society Consensus
Authors: Elena Chiappini
Francesca Santamaria
Gian Luigi Marseglia
Paola Marchisio
Luisa Galli
Renato Cutrera
Maurizio de Martino
Sara Antonini
Paolo Becherucci
Paolo Biasci
Barbara Bortone
Sergio Bottero
Valeria Caldarelli
Fabio Cardinale
Guido Castelli Gattinara
Martina Ciarcià
Daniele Ciofi
Sofia D’Elios
Giuseppe Di Mauro
Mattia Doria
Luciana Indinnimeo
Andrea Lo Vecchio
Francesco Macrì
Roberto Mattina
Vito Leonardo Miniello
Michele Miraglia del Giudice
Guido Morbin
Marco Antonio Motisi
Andrea Novelli
Anna Teresa Palamara
Maria Laura Panatta
Angela Pasinato
Diego Peroni
Katia Perruccio
Giorgio Piacentini
Massimo Pifferi
Lorenzo Pignataro
Emanuela Sitzia
Chiara Tersigni
Sara Torretta
Irene Trambusti
Giulia Trippella
Diletta Valentini
Sandro Valentini
Attilio Varricchio
Maria Carmen Verga
Claudio Vicini
Marco Zecca
Alberto Villani
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Italian Journal of Pediatrics / Issue 1/2021
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/s13052-021-01150-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevention of recurrent respiratory infections

Inter-society Consensus

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2021

Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial

Low prevalence of active trachoma and associated factors among children aged 1–9 years in rural communities of Metema District, Northwest Ethiopia: a community based cross-sectional study

First report of X-linked hypohidrotic ectodermal dysplasia with a hemizygous c.1142G > C in the EDA gene: variant of uncertain significance or new pathogenic variant?

Maternal and neonatal risk factors for neonatal respiratory distress syndrome in term neonates in Cyprus: a prospective case–control study

A case report of Phelan-McDermid syndrome: preliminary results of the treatment with growth hormone therapy

Crohn disease-like enterocolitis remission after empagliflozin treatment in a child with glycogen storage disease type Ib: a case report