Summary and Conclusions
Basic management requires the paediatrician to determine that wheeze is
really present, and that an underlying diagnosis is not being missed.
Symptom based assessments bear little relationship to the presence or
otherwise of the treatable trait of airway eosinophilia. We are
beginning to appreciate that chronic bacterial infection may also be
important, and perhaps some patients will benefit from targeted
antibiotics. A proposed treatment algorithm is shown in the Figure
[47]. The future must be phenotype not history-based treatment, but
it will be essential to convince parents of the merits of this approach.