Therapeutic interventions and pulmonary function in pediatric patients with post-infectious bronchiolitis obliterans

Table 2 Summary table of treatment options

Treatment option	Description	Comments/evidence
Corticosteroids	Systemic or inhaled steroids used to reduce inflammation	Often used during acute exacerbations; long-term benefits uncertain; some improvement in symptoms reported
Bronchodilators	Inhaled β2-agonists and anticholinergics to relieve airway obstruction	Symptomatic relief, but variable response due to fixed airway obstruction
Macrolide antibiotics	Anti-inflammatory and immunomodulatory properties (e.g., azithromycin)	May reduce inflammation; some evidence in other chronic airway diseases; limited data in PIBO
Immunosuppressants	Agents like azathioprine, cyclophosphamide, or mycophenolate mofetil in severe cases	Used in refractory disease; evidence limited; risks of immunosuppression must be balanced
Oxygen therapy	Supplemental oxygen for hypoxemia	Supportive care in advanced disease with chronic hypoxia
Pulmonary rehabilitation	Exercise training, airway clearance, and breathing techniques	Improves quality of life and functional status; standard supportive care
Lung transplantation	Considered in end-stage PIBO with respiratory failure	Rare; only for selected severe cases; long-term outcomes variable
Other therapies	Experimental or adjunctive therapies, including antivirals, mucolytics, or novel agents	Limited evidence; research ongoing; no standard recommendations

PIBO: Post-infectious bronchiolitis obliterans.