title: The use of inhaled corticosteroids in pediatric asthma: update.
abstract: Despite the availability of several formulations of inhaled corticosteroids (ICS) and delivery devices for treatment of childhood asthma and despite the development of evidence-based guidelines, childhood asthma control remains suboptimal. Improving uptake of asthma management plans, both by families and practitioners, is needed. Adherence to daily ICS therapy is a key determinant of asthma control and this mandates that asthma education follow a repetitive pattern and involve literal explanation and physical demonstration of the optimal use of inhaler devices. The potential adverse effects of ICS need to be weighed against the benefit of these drugs to control persistent asthma especially that its safety profile is markedly better than oral glucocorticoids. This article reviews the key mechanisms of inhaled corticosteroid action; recommendations on dosage and therapeutic regimens; potential optimization of effectiveness by addressing inhaler technique and adherence to therapy; and updated knowledge on the real magnitude of adverse events.
authors.affiliation: Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, 11566 Egypt.
authors.forename: Elham
authors.initials: E
authors.lastname: Hossny
authors.affiliation: Federal University of Parana, Curitiba, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Rosario
authors.affiliation: Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore ; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Bee Wah
authors.initials: BW
authors.lastname: Lee
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Meenu
authors.initials: M
authors.lastname: Singh
authors.affiliation: Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, 11566 Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: El-Ghoneimy
authors.affiliation: Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore ; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Jian Yi
authors.initials: JY
authors.lastname: Soh
authors.affiliation: Winthrop Professor of Paediatrics & Child Health, School of Paediatrics & Child Health, University of Western Australia, Crawley, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Le Souef
keywords: Adherence; Adverse effects; Asthma; Children; Inhaled corticosteroids