Number Of Upper Respiratory Tract Infections Episodes Research Articles

Efficacy of Montelukast for Prevention of Upper Respiratory Tract Infection in Children: A Randomized, Placebo-Controlled Trial

Background: Upper Respiratory tract infection (URTI) or common cold is very prevalent in children particularly in young children. Leukotriene receptor antagonists (LTRAs) like montelukast are effective drugs in asthma and some other respiratory diseases. Our purpose was to study preventive effects of montelukast on pediatric URTI. Methods: This randomized, placebo-controlled, and double blind trial was performed on 450 healthy children aged 1-5 year in Amir Kabir Hospital, Arak, Iran. Children were randomized 1:1 to placebo group or montelukast group for 12 weeks. Number of URTI episodes and duration were the primary end points and were compared at baseline and after termination of treatment. Results: Mean age was 28 ± 12.3 months. Mean of URTI episodes was 0.7 ± 0.57 in children treated with montelukast and 1.27 ± 0.72 in children treated with placebo, respectively. Differences were statistically significant (P =0.01). A significant difference was seen in URTI duration between two study groups (6.3 ± 6.1 vs 4.1 ± 3.9, P = 0.05). In addition, duration of fever was shorter in children receiving montelukast (P=0.001). Conclusion: Our study indicates that 3 month treatment with montelukast is effective for reducing the incidence of URTI in young children. This treatment has an acceptable safety without any serious concern.

Beverage Containing Dispersible Yeast β-Glucan Decreases Cold/Flu Symptomatic Days After Intense Exercise: A Randomized Controlled Trial

In this double-blind, randomized, placebo-controlled parallel study, we examined the effect of dairy-based beverages (250 mL/day) containing 250 mg of dispersible baker’s yeast β-glucan (Wellmune) compared to a macronutrient- and calorie-matched control on upper respiratory tract infection (URTI) in marathon runners. Healthy adults running in the 2017 Austin Marathon consumed either β-glucan (N = 132) or control (N = 225) for the 45 days prior to, day of, and 45 days after the marathon (91 days total). Participants completed a daily online survey assessing compliance, training status, and URTI symptoms. URTI occurrence and severity were evaluated using the Jackson Index and confirmed by the study physician. No significant differences in average duration and number of URTI episodes were found between β-glucan and control. However, those who completed the study per protocol on the β-glucan beverage reported significantly fewer URTI symptomatic days (3.43 ± 6.44 days, max 27 days) compared to those on control beverage (3.84 ± 6.84 days, max 49 days). Total URTI severity was significantly lower for β-glucan (4.52 ± 1.61) compared to control (5.60 ± 2.23). Specifically, lower (p < .05) severity ratings for nasal discharge and sore throat were reported for β-glucan compared to control. Average missed postmarathon workout days due to URTI were significantly less for β-glucan (0.09 ± 0.38 days, max 2 days) compared to control (0.36 ± 1.40 days, max 10 days). Overall, consumption of dairy-based beverages containing dispersible yeast β-glucan decreased URTI symptomatic days, severity of specific URTI symptoms, and missed postmarathon workout days due to URTI, without affecting duration and number of URTI episodes.

Association between oral health and upper respiratory tract infection among children

The oral cavity is a potential reservoir for respiratory pathogens. This longitudinal study investigated the association between upper respiratory tract infection (URI) and oral health among children. A total of 288 children aged 4 years were recruited. Their dental caries and oral hygiene status were clinically determined, using the dmft (decayed, missing and filled teeth) index and the Silness-Löe plaque index. Questionnaires were completed by parents to collect information on the child's socio-demographic background and URI episodes and symptoms in the following 12 months. Standard or zero-inflated negative binomial regressions were used to analyse the association between URI and both oral health indicators (dmft and plaque score). Some 138 (47.9%) children had URI in 12 months, including 63 (21.9%) and 75 (26.0%) children with 1-2 episodes and ≥3 episodes, respectively. The reported URI episodes fell into two peaks, coinciding with the two influenza peaks in Hong Kong. Significantly a higher dmft was found among children without URI compared with children who had ≥3 URI episodes (1.32 vs. 0.49; P = 0.043). The number of URI episodes was inversely associated with dmft (IRR = 0.851; 95% CI: 0.766-0.945; P = 0.003). There was no significant association between the plaque score and URI (P > 0.05). The children's caries experience was associated with reduced episodes of URI. Whether this inverse association is attributed to the immune response induced by dental caries is yet to be investigated.

Effect of Vitamin D3Supplementation on Upper Respiratory Tract Infections in Healthy Adults

Observational studies have reported an inverse association between serum 25-hydroxyvitamin D (25-OHD) levels and incidence of upper respiratory tract infections (URTIs). However, results of clinical trials of vitamin D supplementation have been inconclusive. To determine the effect of vitamin D supplementation on incidence and severity of URTIs in healthy adults. Randomized, double-blind, placebo-controlled trial conducted among 322 healthy adults between February 2010 and November 2011 in Christchurch, New Zealand. Participants were randomly assigned to receive an initial dose of 200,000 IU oral vitamin D3, then 200,000 IU 1 month later, then 100,000 IU monthly (n = 161), or placebo administered in an identical dosing regimen (n = 161), for a total of 18 months. The primary end point was number of URTI episodes. Secondary end points were duration of URTI episodes, severity of URTI episodes, and number of days of missed work due to URTI episodes. The mean baseline 25-OHD level of participants was 29 (SD, 9) ng/mL. Vitamin D supplementation resulted in an increase in serum 25-OHD levels that was maintained at greater than 48 ng/mL throughout the study. There were 593 URTI episodes in the vitamin D group and 611 in the placebo group, with no statistically significant differences in the number of URTIs per participant (mean, 3.7 per person in the vitamin D group and 3.8 per person in the placebo group; risk ratio, 0.97; 95% CI, 0.85-1.11), number of days of missed work as a result of URTIs (mean, 0.76 days in each group; risk ratio, 1.03; 95% CI, 0.81-1.30), duration of symptoms per episode (mean, 12 days in each group; risk ratio, 0.96; 95% CI, 0.73-1.25), or severity of URTI episodes. These findings remained unchanged when the analysis was repeated by season and by baseline 25-OHD levels. In this trial, monthly administration of 100,000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults. anzctr.org.au Identifier: ACTRN12609000486224.

Daily Probiotic’s (Lactobacillus casei Shirota) Reduction of Infection Incidence in Athletes

The purpose of this study was to examine the effects of a probiotic supplement during 4 mo of winter training in men and women engaged in endurance-based physical activities on incidence of upper respiratory-tract infections (URTIs) and immune markers. Eighty-four highly active individuals were randomized to probiotic (n = 42) or placebo (n = 42) groups and, under double-blind procedures, received probiotic (PRO: Lactobacillus casei Shirota [LcS]) or placebo (PLA) daily for 16 wk. Resting blood and saliva samples were collected at baseline and after 8 and 16 wk. Weekly training and illness logs were kept. Fifty-eight subjects completed the study (n = 32 PRO, n = 26 PLA). The proportion of subjects on PLA who experienced 1 or more weeks with URTI symptoms was 36% higher than those on PRO (PLA 0.90, PRO 0.66; p = .021). The number of URTI episodes was significantly higher (p < .01) in the PLA group (2.1 ± 1.2) than in the PRO group (1.2 ± 1.0). Severity and duration of symptoms were not significantly different between treatments. Saliva IgA concentration was higher on PRO than PLA, significant treatment effect F(1, 54) = 5.1, p = .03; this difference was not evident at baseline but was significant after 8 and 16 wk of supplementation. Regular ingestion of LcS appears to be beneficial in reducing the frequency of URTI in an athletic cohort, which may be related to better maintenance of saliva IgA levels during a winter period of training and competition.

Physical Activity and Upper Respiratory Tract Infections

We explored the relationship of current and lifetime physical activity (PA) with upper respiratory tract infections (URTI) symptomatology in 142 male volunteers aged 33 to 90. They participated in baseline and one-year follow-up examinations and fulfilled the log books for daily recording of URTI symptomatology during the whole year. PA was assessed by the Seven Day Recall PA Questionnaire and the Historical Leisure Activity Questionnaire. Number of URTI episodes per year and the number of days with URTI per year were significantly inversely associated with the follow-up 7-Day Recall Hard score (rho = - 0.21; p = 0.013 and rho = - 0.18; p = 0.032, respectively). In logistic regression model, after adjustment for age and anthropometric data, the subjects with high follow-up 7-Day Recall Hard score (dichotomised as high vs. low) had a lower probability of having at least 2 URTI episodes per year (OR = 0.38; CI = 0.18 - 0.78), lower probability of having at least 3 URTI episodes per year (OR = 0.42; CI = 0.20 - 0.87), and lower probability of having at least 15 days with URTI (OR = 0.36; CI = 0.15 - 0.88). URTI symptomatology was not related to cardiorespiratory fitness or any measures of the historical PA questionnaire. We conclude that in middle-aged and older men the symptomatology of URTI over long periods of time is inversely related to current but not to lifetime PA.

The incidence of post-race symptoms of upper respiratory tract infection in wheelchair marathon racers

Prospective analysis. To investigate the influence of exercise and major competition on infectious episodes in athletes with spinal cord injuries (SCI). Japan. We examined the self-reported infectious episodes of upper respiratory tract infection (URTI) in athletes with SCI during a 1-month period before the race and 2 weeks after the race. The study included 21 persons with SCI who participated in the 18th Oita International Wheelchair Marathon. Thirteen persons with SCI who did not participate in the race were studied as control subjects. The number of URTI episodes in marathoners was 0.086+/-0.036/week during the 1-month period before the race and 0.089+/-0.040/week during the 2-week post-race period, whereas that of the controls was 0.139+/-0.046/week during the 1-month period before the race and 0.072+/-0.047/week during the 2-week post-race period. There were no significant differences between before and after the race in marathoners, or between marathoners and controls during each period. However, the number of URTI episodes 2 weeks after the race was significantly higher in subjects who trained more than 65 km/week compared to those who trained less than 65 km/week. In subjects with SCI who completed a wheelchair full marathon race, the incidence of URTI after the race was not high compared to control subjects who did not participate in the race. According to the number of URTI episodes and the training data, it is recommended that wheelchair marathoners should consider their risk for URTI during excessive practice.

Factors triggering upper airway infections in athletes

Clinical and epidemiological data suggest that strenuous exercise increases the incidence of upper respiratory tract infections (URTI) in athletes. However, little is known if the risk for URT infections is associated with the type of sports performed (e.g., endurance vs. strength exercise, or mixed sports) or whether accompanying lifestyle factors such as dietary behavior, daily stress, and the intake of nutritional supplements or immunostimulants influence the incidence of URT infections. In order to increase our knowledge on such questions, 852 athletes who attended our outpatient department for sports medicine filled out a retrospective questionnaire (1-year self-recalled) dealing with the following questions: number of URTI episodes in the last 12 months; number of training days lost due to URTI; type of exercise (endurance/power/mixed type/swimming); training extent; special procedures for regeneration (e.g., physiotherapy); lifestyle and daily stress; dietary behavior; intake of nutritional supplements; and use of immunostimulants. Of the respondents, 72.1% reported one or more URTI episodes in the last 12 months. In a multiple-regression model, the following variables were positive predictors of an URTI episode: endurance sports [odds ratio, 2.15; CI (95%), 1.51–3.06; p < .000], daily stress [odds ratio, 1.97; CI (95%), 1.26–3.08; p < .01], sleep deprivation [odds ratio, 1.69; CI (95%), 1.14–2.5; p < .01], female gender (odds ratio, 1.5; CI [95%] 1.05–2.13; p < .05),training extent in hour per week [odds ratio, 1.05; CI (95%), 1.02–1.08; p < .01), and diet control [odds ratio, 0.6; CI (95%), 0.37–0.82; p < .01]. The positive predictive value of this model for URTI episodes was 76%. Subgroup analysis revealed that in athletes exhibiting the highest rate of infections, use of immunostimulants reduced the number of training days lost (2 days) due to infections. In conclusion, both sports-specific items as well as lifestyle variables contribute substantially in explaining the risk for athletes to develop respiratory infections. These findings should be considered in sports-specific training regimes, particularly in athletes prone to URT infections.

Antibiotics for Colds in Children

To examine physician characteristics associated with being a high prescriber of antibiotics for pediatric upper respiratory tract infections (URIs). Analysis of 34624 episodes of care for URIs in children (younger than 18 years) in the Kentucky Medicaid program from July 1, 1995, to June 30, 1996. Primary care physicians with at least 25 episodes of care (n=205). The proportion of patients with URIs receiving antibiotics stratified the sample into low (< or =25th percentile) and high (> or =75th percentile) antibiotic prescribers. Bivariate analyses were computed comparing the high and low prescribers. A logistic regression model was computed for likelihood of being a high prescriber by number of URI episodes, proportion of patients receiving antibiotics that were broad spectrum, years since medical school graduation, physician gender, rural/urban practice, and specialty. The high prescriber group (n=52) included data from 11899 episodes of care, with a mean prescribing rate of 80%. The low prescriber group (n=55) included data from 5396 episodes, with a mean prescribing rate of 16%. High prescribers were significantly more years away from medical school graduation (27 vs 19 years; P<.001) and had managed significantly more URI episodes than low prescribers (229 vs 98; P=.001). In the logistic regression, compared with pediatricians, the odds ratios of being a high prescriber were 409 (95% confidence interval [CI], 29-7276) for family practitioners and 318 (95% CI, 17-6125) for other primary care physicians. With the rise of antibiotic-resistant bacteria, more focused training regarding treatment of URIs is warranted in residency and in continuing medical education forums.