The clinical question is an important one. The use of montelukast in preschool wheeze is recommended in the British Thoracic Society (BTS) guidelines ; it is widely used across the world and should only be recommended if it is actually helpful. The added value of this study compared to the recent Cochrane review  is the inclusion of all types of preschool wheeze; therefore, more akin to real life, it therefore makes the clinical question more relevant and clinically applicable. Our primary outcome measure was also very clinically relevant, being number of wheezy episodes.