title: The role of inhaled corticosteroids in management of asthma in infants and preschoolers.
abstract: OBJECTIVE
  This review analyses published data on the treatment of wheezing in infants and preschoolers with inhaled corticosteroids (ICS), including the effect in subgroups of patients such as 'multiple trigger wheeze' and 'episodic viral wheeze'.
  
  
  RESULTS
  Therapy with ICS at daily doses of 100-200  μg results in significant clinical improvements in several outcomes in preschoolers and infants suspected of having asthma (multiple trigger wheeze). Such treatment is normally considered well tolerated. Although not well studied, higher daily doses may be associated with measurable effects on growth, which are not cumulative with continued treatment. In children who only wheeze in association with viral infections (episodic viral wheeze), preemptive treatment with high doses of ICS has demonstrated significant clinical effects on several outcomes, whereas lower doses seem to have little effect. Intermittent use of high doses of ICS has been associated with significant reductions in height and weight gain over 1 year.
  
  
  CONCLUSIONS
  The review illustrates the complexity of treating wheezing in infants and preschoolers and interpreting the study results. It emphasizes the need for more studies in clinical subgroups, more long-term studies and dose-response studies to assess the optimal doses and safety of intermittent as well as regular ICS treatment.
authors.affiliation: Department of Pediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile. jacastro17@hotmail.com
authors.forename: Jose A
authors.initials: JA
authors.lastname: Castro-Rodriguez
authors.forename: Søren
authors.initials: S
authors.lastname: Pedersen
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002675:Child, Preschool; D019468:Disease Management; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007223:Infant; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones