Recurrent Upper Respiratory Tract Infections in Children: A Narrative Review of Epidemiology, Clinical Challenges, and Future Directions

This is the authors' abstract. We don't add key points for this paper.

Recurrent upper respiratory tract infection (rURTI) represents one of the most common clinical problems in children, imposing substantial morbidity, antibiotic overuse, and significant burdens on families and healthcare systems. This narrative review examines the epidemiology of rURTI in both global and Indian contexts, describes the major clinical presentations and current treatment approaches, and explores ongoing research into pathophysiology and innovative therapies. The discussion provides a comprehensive analysis of factors contributing to the increasing trend of rURTI, including pathophysiological mechanisms involving mucosal immunity, the adenoid reservoir, and microbiome alterations. A structured approach to children with rURTI is presented, along with the latest developments in bacteriotherapy, immunomodulation, and surgical interventions. Future perspectives, including the role of government policies, initiatives by the World Health Organization and the Centers for Disease Control and Prevention, and vaccine strategies, are critically evaluated. The review identifies knowledge gaps and proposes recommendations for clinical practice and future research.