[Guideline 'Treating asthma in children' for pediatric pulmonologists (2nd revised edition). II. Medical treatment].
The second revision of the guidelines for the treatment of asthma in children is largely based on the evidence of comparative studies. Short-acting beta 2-sympathicomimetics are the medication of choice for acute exacerbations and should therefore be prescribed to each patient. Inhaled corticosteroids (ICS) are the medication of choice for maintenance treatment. Starting with a high dose of ICS which is then reduced to a lower but effective level on the basis of the complaints (step-down approach) is no longer recommended, as this strategy is not more effective than a constant dosage schedule. If asthmatic symptoms persist despite ICS maintenance treatment then 3 therapeutic options are available in the following order: doubling the ICS dose, the addition of a long-acting beta 2-sympathicomimetic, and the addition of a leukotriene receptor antagonist.
Duiverman
E J
EJ
Academisch Ziekenhuis, Beatrix Kinderkliniek, afd. Kindergeneeskunde, sectie Kinderlongziekten, Postbus 30.001, 9700 RB Groningen. e.j.duiverman@bkk.azg.nl
Brackel
H J
HJ
Merkus
P J
PJ
Rottier
B L
BL
Brand
P L
PL
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D055502:Secondary Prevention; D013566:Sympathomimetics / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D013566:Sympathomimetics