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Volume 14
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10.3390/jcm14030848
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Airway Colonization in Children with Medical Complexity: Challenges and Management Strategies

by
Valentina Fainardi
,
Luisa Rizzo
,
Giulia Zambelli
,
Martina Berzieri
,
Erika Maugeri
,
Elena Giacalone
,
Roberta Carbone
,
Maria Carmela Pera
and
Susanna Esposito
*
Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(3), 848; https://doi.org/10.3390/jcm14030848
Submission received: 5 December 2024 / Revised: 16 January 2025 / Accepted: 21 January 2025 / Published: 27 January 2025
(This article belongs to the Special Issue Pediatric Pulmonology: Recent Developments and Emerging Trends)
Versions Notes

Abstract

Over recent years, advances in medical care have significantly improved the survival of children with severe chronic conditions. These children, referred to as children with medical complexity (CMC), present unique and demanding healthcare challenges. Although definitions of CMC remain inconsistent, these patients are typically characterized by chronic, often severe conditions requiring daily specialized treatments and the use of various medical devices. CMC represent a substantial burden for healthcare systems due to their high medical costs, and place considerable strain on caregivers, who must provide continuous assistance. Airway colonization by pathogens such as Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and Haemophilus influenzae is common in CMC and contributes to recurrent respiratory infections, increased hospitalizations, and progressive lung damage. The management of airway colonization in this population is a topic of ongoing debate, often involving a combination of airway clearance techniques (ACT) and antibiotic therapies. Antibiotics may be administered systemically, nebulized, or in combination, depending on the clinical context and severity of the condition. This review highlights the complexities of managing airway colonization in CMC, emphasizing the need for tailored therapeutic approaches to mitigate respiratory complications and improve outcomes.
Keywords: airway clearance therapy; airway colonization; antibiotics; medical complexity; respiratory infections airway clearance therapy; airway colonization; antibiotics; medical complexity; respiratory infections

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MDPI and ACS Style

Fainardi, V.; Rizzo, L.; Zambelli, G.; Berzieri, M.; Maugeri, E.; Giacalone, E.; Carbone, R.; Pera, M.C.; Esposito, S. Airway Colonization in Children with Medical Complexity: Challenges and Management Strategies. J. Clin. Med. 2025, 14, 848. https://doi.org/10.3390/jcm14030848

AMA Style

Fainardi V, Rizzo L, Zambelli G, Berzieri M, Maugeri E, Giacalone E, Carbone R, Pera MC, Esposito S. Airway Colonization in Children with Medical Complexity: Challenges and Management Strategies. Journal of Clinical Medicine. 2025; 14(3):848. https://doi.org/10.3390/jcm14030848

Chicago/Turabian Style

Fainardi, Valentina, Luisa Rizzo, Giulia Zambelli, Martina Berzieri, Erika Maugeri, Elena Giacalone, Roberta Carbone, Maria Carmela Pera, and Susanna Esposito. 2025. "Airway Colonization in Children with Medical Complexity: Challenges and Management Strategies" Journal of Clinical Medicine 14, no. 3: 848. https://doi.org/10.3390/jcm14030848

APA Style

Fainardi, V., Rizzo, L., Zambelli, G., Berzieri, M., Maugeri, E., Giacalone, E., Carbone, R., Pera, M. C., & Esposito, S. (2025). Airway Colonization in Children with Medical Complexity: Challenges and Management Strategies. Journal of Clinical Medicine, 14(3), 848. https://doi.org/10.3390/jcm14030848

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