title: Special considerations--asthma in children.
abstract: BACKGROUND
  Asthma is among the most common chronic diseases of childhood. Management of pediatric asthma requires an understanding of the issues that uniquely effect children. This review provides the reader with the current state and future directions of pediatric asthma.
  
  
  METHODS
  Review of the pediatric asthma literature was undertaken with emphasis on randomized controlled trials and systematic reviews.
  
  
  RESULTS
  The prevalence of pediatric asthma remains elevated and is increasingly being appreciated in select global regions. Effective treatment in any setting begins with a focused medical history that queries key asthma features that inform both diagnostic and monitoring strategies. A thorough medical history may yield comorbid upper airway disorders and allergic triggers that could potentially exacerbate airway inflammation. Pre-bronchodilator and post-bronchodilator lung function testing is a preferable diagnostic strategy to quantitatively assess obstructive pulmonary disease among children capable of performing the testing maneuvers. Pediatric asthmatics who continue to have poor disease control require monitoring of medication adherence and drug delivery techniques, because both are often linked with disease outcomes. Therapeutic strategies in children are notably distinct from adults due to the possible effects of inhaled corticosteroids on reduced bone mineral density and growth. Adolescents may also require more time to address the psychosocial complexities that may complicate the required daily usage of asthma medicines.
  
  
  CONCLUSIONS
  Asthmatic children are distinct from their adult counterparts due to limitations inherent in the pediatric age group. A unified and evidence-based approach to pediatric asthma may improve clinical outcomes.
authors.affiliation: Division of Pediatric Pulmonology, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Jassal
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D006801:Humans; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents
keywords: child; cough; lung diseases; obstructive; pulmonary medicine; review; wheezing