Update in paediatric asthma management: Where is evidence challenging current practice?

Authors

  • Paul D Robinson,

    Corresponding author
    1. Department of Respiratory Medicine, The Children's Hospital at Westmead
    2. The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney
    3. The Woolcock Medical Research Institute, Sydney, New South Wales, Australia
      Dr Paul D Robinson, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 98453396; email: paulr3@chw.edu.au
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  • Peter Van Asperen

    1. Department of Respiratory Medicine, The Children's Hospital at Westmead
    2. The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney
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Dr Paul D Robinson, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 98453396; email: paulr3@chw.edu.au

Abstract

Extrapolation of management strategies based on results from predominantly adult asthma studies frequently occurs in paediatric asthma despite increasing evidence that paediatric asthma and, in particular, pre-school recurrent wheeze are very different disease entities. Response to medications in paediatric subjects is often different from that seen in their older adolescent and adult counterparts. In this update, we discussed recent studies that have had important implications for future paediatric asthma management. The overuse of combination inhaled steroid and long-acting beta2 agonist inhalers in paediatric asthma despite ongoing safety concerns is an increasing trend in paediatric asthma, and recent evidence has helped clarify how they should be used in children. Other aspects discussed include the role of oral corticosteroids in pre-school viral-induced wheeze and the utility of leukotriene receptor antagonists in exercise-induced asthma.

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