The five main unmet needs in the treatment of asthma in children and adolescents are the treatment of infants, the treatment of adolescents, the efficacy of medication, the lack of clinical trials in children and the need for prevention. Asthma is a dynamic disease that changes over time and there are several patterns of asthma in children. One of the greatest needs is to identify those children with chronic asthma where undertreatment is more of a problem than overtreatment. Although the treatment of asthma in children is the same in principle as adults, there are several practical difficulties with infants, such as accurately assessing lung function and administering drugs. Teenage asthma creates a distinct management problem. Not only is asthma underdiagnosed but acceptance of diagnosis and compliance is often poor. Existing therapies need to be used more effectively in adolescents. It is particularly important to establish a partnership with teenage asthmatics and motivate them to create their own treatment goals. This requires passing on knowledge. The efficacy of asthma medication may be different in children than in adults and clinical studies should be performed to optimize therapy with existing drugs. The only proven primary preventive measure to prevent wheezing and asthma is to avoid passive tobacco smoke exposure. Possible intervention strategies include early intervention with anti-inflammatory therapy, allergen avoidance and vaccine approaches but more of them have proven efficacious. Although modern asthma treatment has improved patient quality of life and long-term prognosis, there is still a need for further improvement.
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