Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-03-21T17:07:14Z No. of bitstreams: 1 TES_CLARISSA_AIRES_ROZA_PARCIAL.pdf: 507622 bytes, checksum: afb3f324ad1f25c628f444e32084d5b7 (MD5) / Made available in DSpace on 2017-03-21T17:07:14Z (GMT). No. of bitstreams: 1 TES_CLARISSA_AIRES_ROZA_PARCIAL.pdf: 507622 bytes, checksum: afb3f324ad1f25c628f444e32084d5b7 (MD5) Previous issue date: 2016-05-25 / Introduction: Acute bronchiolitis (AB) is the most common disease of the lower airways in infants. There is disagreement in the literature on the AB definition, especially in relation to age and recurrence of symptoms. As some children may develop post-bronchiolitis recurrent wheezing, it has been widely studied interventions to prevent recurrence wheezing. Methods: A systematic literature review was conducted in MEDLINE with filter for "clinical trial" and the search term was "acute bronchiolitis?. It was established two distinct groups of setting: 1-first episode of wheezing and 2-clinical presentation of AB below 24 months of age, regardless of recurrence. Furthermore, we conducted a double-blind randomized placebo-controlled trial with patients admitted for AB to test the hypothesis that use of azithromycin in the acute episode of AB may reduce the risk of recurrent wheezing. Results: The systematic review included 79 trials and showed that the majority (59.49%) defines AB as the first episode of wheezing in infants and 56.96% includes children under 12 months. The trial included 91 patients (51 in the azithromycin group and 40 in the placebo group). The risk of hospital readmission was not different between the groups studied 1, 3 and 6 months after AB. The risk of recurrent wheezing was significantly reduced up to 6 months after admission for AB (p = 0.022). Conclusion: AB definition used by most clinical trials was the first episodes of wheezing in children, and most of the studies included patients up to 12 months. Therefore, this should be the definition used in guidelines and documents ofrecommendations. The use of azithromycin in the first episode of AB reduces the risk of recurrent wheezing in infants. / Introdu??o: A bronquiolite aguda (BA) ? a doen?a mais comum das vias a?reas inferiores. H? diverg?ncias importantes na literatura sobre a defini??o de BA, principalmente em rela??o ? idade e ? recorr?ncia dos sintomas. Como algumas crian?as podem desenvolver sibil?ncia recorrente ap?s epis?dio agudo de BA, tratamentos t?m sido avaliados com o objetivo de prevenir tal recorr?ncia. M?todos: Foi realizada uma revis?o sistem?tica da literatura na base de dados MEDLINE com filtro ?clinical trial? e o termo de busca foi ?acute bronchiolitis?. Estabeleceram-se dois grupos distintos de defini??o: 1- primeiro epis?dio de sibil?ncia e 2- quadro cl?nico de BA abaixo de 24 meses de idade,independente da recorr?ncia. Al?m disso, foi realizado ensaio cl?nico randomizado (ECR) duplo-cego controlado por placebo com pacientes internados por BA para testar a hip?tese de que uso de azitromicina no epis?dio agudo de BA reduza o risco de sibil?ncia recorrente. Resultados: A revis?o sistem?tica incluiu 79 ensaios cl?nicos e mostrou que a maioria (59,49%) define BA como o primeiro epis?dio de sibil?ncia na inf?ncia e que 56,96% incluem crian?as abaixo de 12 meses de idade. O ensaio cl?nico incluiu 91 pacientes (51 no grupo azitromicina e 40 no grupo placebo). O risco de readmiss?o hospitalar n?o foi diferente entre os grupos estudados 1,3 e 6 meses ap?s a BA. O risco de sibil?ncia recorrente foi significativamente reduzido em um seguimento de 6 meses ap?s admiss?o por BA (p =0.022). Conclus?o: A defini??o de BA mais utilizada pelos ensaios cl?nicos foi o primeiro epis?dio de sibil?ncia na inf?ncia, sendo que a maioria dos estudos incluiu pacientes de no m?ximo 12 meses de idade. Portanto, recomenda-se a utiliza??o dessa defini??o em guidelines ou documentos de recomenda??es. Ainda, o ECR demonstrou que o uso de azitromicina no epis?dio agudo de BA reduz o risco de sibil?ncia recorrente em lactentes nos primeiros 6 meses ap?s o epis?dio agudo.